We would be grateful if you could return the completed form by to Kathy Barrett by at

Transcription

1 We would be grateful if you could return the completed form by to Kathy Barrett by at Or attach as a file in Messenger PRE-ADOPTION FORM FOR Semper Fidelis Domus Shelter PLEASE COMPLETE AS FULLY AS POSSIBLE DATE OF APPLICATION NAME, PADDOCK NUMBER AND DOG NUMBER OF DOG YOU ARE INTERESTED IN ADOPTING SECTION 1 APPLICANT DETAILS NAME: ADDRESS INCLUDING POSTCODE: LANDLINE TELEPHONE: MOBILE TELEPHONE: ADDRESS: DATE OF BIRTH: AREA OF HOME (COUNTY OR TOWN & COUNTRY): SECTION 2 PROPERTY TYPE TYPE OF PROPERTY: FLAT, HOUSE, BEDROOMS, TERRACE, etc RENTED OR OWNED: 1

2 IF RENTED, DO YOU HAVE THE LANDLORDS PERMISSION TO KEEP ANIMALS? PROOF IN WRITING IS NEEDED AND PHOTO PROOF SENT WITH THIS FORM IS THE PROPERTY ON OR CLOSE TO A BUSY MAIN ROAD/TYPE OF ROAD HOME IS ON? WHAT SIZE IS THE GARDEN : HOW HIGH ARE THE FENCES SURROUNDING THE GARDEN? ARE THERE ANY GAPS? MINIMUM OF 5FT SECURE FENCING. ARE GARDEN GATES SOLID AND SECURE? IF SO, HOW? COULD THE DOG ESCAPE BY JUMPING/DIGGING? IS THE FRONT DOOR SECURE? IS THE GARDEN BIG ENOUGH TO ACCOMMODATE A DOG AND WHERE WOULD THE DOG GO TO THE TOILET? ARE YOU INTENDING TO MOVE HOUSE IN NEXT 12 MONTHS? SECTION 3 RESIDENTS AT THE PROPERTY HOW MANY PEOPLE LIVE IN THE PROPERTY ADULTS: CHILDREN: IS EVERYONE IN THE HOUSEHOLD HAPPY TO HAVE A DOG FROM OVERSEAS? (ANY CONCERNS?) AGES OF CHILDREN: ARE ANY NEW BABIES PLANNED/EXPECTED: HAS THE DECISION TO ADOPT OR FOSTER BEEN DISCUSSED WITH THE FAMILY? WHAT ARE THE AGES OF CHILDREN WHO VISIT THE PROPERTY? DO YOU/YOUR PARTNER WORK, IF SO FOR HOW MANY HOURS WILL THE DOG BE LEFT ALONE? ARE THERE ANY RESIDENT DOGS OR CATS? ANY SMALL PETS LIVING INDOORS? ANY CONCERNS? 2

3 IF YES, WHAT ARE THEIR BREED, AGES AND ARE THEY NEUTERED AND VACCINATED: BEHAVIOUR/TEMPERAMENT OF RESIDENT PETS AND ANY CONCERNS: IF NO RESIDENT DOGS HAVE YOU OWNED A DOG BEFORE? HAVE YOU EVER GIVEN UP (REHOMED) A DOG FOR ANY REASON? IS ANYONE IN THE HOME BANNED FROM KEEPING PETS: DOES ANYONE IN THE HOME HAVE A DISABILITY OR EXISTING ILLNESS THAT COULD AFFECT THE FUTURE CARE OF A DOG OR ITS WELFARE; ANYONE WITH ALLERGIES TO BE AWARE OF? SECTION 4 CARE OF THE DOG WHO WOULD WALK THE DOG AND HOW OFTEN? WHERE WOULD THE DOG SLEEP? DIET IS IMPORTANT TO DOGS. WHAT ARE YOU INTENDING TO FEED HIM/HER ON? PLEASE GIVE YOUR VET DETAILS: THIS MUST BE GIVEN FOR A REFERENCE, IF THEY HAVE NO PETS THEN WE SHALL EXCEPT NO VET DETAILS. AGREE TO NEUTER AFTER 6 MONTHS OF AGE? KEEP VACCINATIONS/FLEA AND WORMING TREATMENTS UP TO DATE? HOW WILL YOU TRANSPORT YOUR DOG TO THE VET: DO YOU INTEND TO TAKE OUT PET INSURANCE? WHEN ALONE WILL THE DOG BE CAGED? HOW WILL YOU TRAVEL THE DOG IN A CAR? IF YOU GO AWAY ON HOLIDAY OR OVERNIGHT WHAT PROVISION WOULD BE MADE FOR THE DOG? 3

4 WOULD THE DOG HAVE THE FULL RUN OF THE HOUSE: WHERE WOULD YOU KEEP THE DOG WHILST YOU WERE OUT OF THE HOUSE: SHOULD YOU BECOME ILL, NEED HOSPILISATION, OPERATION ETC, WHAT WILL HAPPEN TO YOUR DOG. We believe a dog is better staying in the home they are settled in, even if means they can t be walked, than enduring the trauma of moving homes: YOUR DOG MAY NOT BE VACCINATED FULLY WHEN ARRIVING. YOU CAN T WALK A DOG UNTIL VACCINATED. DO YOU AGREE TO THIS? SECTION 5 INTRODUCTION OF DOG TO FAMILY WHAT PREPARATIONS WILL YOU/HAVE YOU MADE FOR THE ARRIVAL OF YOUR DOG: DO YOU HAVE A CRATE AND/OR STAIRGATES IN ORDER TO SEPARATE DOGS WHILST INTRODUCING. SEPARATE ROOMS FOR CATS. HOW WILL YOU INTRODUCE YOUR NEW DOG TO CHILDREN: HOW WOULD YOU INTRODUCE YOUR RESIDENT DOGS/CATS TO YOUR NEW DOG: SECTION 6 SETTLING IN AND TRAINING UNDERSTANDING THAT THE DOG MAY NOT BE HOUSE TRAINED? UNDERSTANDING OF TOILET TRAINING? WILLING TO LOOK FOR GUIDANCE ON THIS? ARE YOU HAPPY TO TAKE A DOG THAT HAS MEDICAL/BEHAVIOUR DIFFICULTIES: WHAT ARE YOUR VIEWS ON SMACKING THE DOG OR HOW ELSE WOULD YOU GO ABOUT PROMOTING AUTHORITY WHERE WILL THE DOG BE FED AND HOW WILL YOU DEAL WITH FOOD AGGRESSION HOW WOULD YOU MANAGE SEPARATION ANXIETY ISSUES 4

5 WOULD YOU TAKE ADVICE ON BEHAVOURIAL ISSUES FROM A TRAINER HAVE YOU RESEARCHED THE BREED YOU ARE LOOKING FOR HAVE YOU RESEARCHED THE WHOLE CONCEPT OF ADOPTING A DOG A FROM ROMANIAN SHELTER? Have you returned a dog to the shelter before? Please give details. ANY ISSUES YOU HAVE WITH THE DOGS THAT YOU CAN T HANDLE WILL YOU CONTACT REACHING OUTFOR ADVICE? HAVE YOU CONSIDERED THE FINANCIAL IMPLICATIONS OF FOOD, BEDDING, VET BILLS, TOYS WORMER, DEFLEA, POSSIBLY A SPECIAL DIET /FOOD IN THE EVENT THAT YOUR DOG NEEDS TO BE MOVED FROM YOUR HOME, ARE YOU ABLE TO SEPARATE UNTIL THIS CAN BE ARRANGED. WHAT DO YOU HAVE IN PLACE TO BE ABLE TO SEPARATE, IE CRATE, STAIR GATES: (We endeavour to do this as fast as possible but we are reliant on organising transport and we cannot remove a dog instantly or within hours so please don t expect us to.) IF FOSTERING, DO YOU FOSTER FOR ANY OTHER RESCUES: IF SO PLEASE INDICATE WHO, WHO IS RESCUE CONTACT AND HOW LONG FOR: PLEASE PROVIDE PHOTOS OF 2 ITEMS OF IDENTITY, anything official, driving licence, passport, council tax etc. 5

6 As well as a Homecheck following receipt of this application, we shall need to seek an experienced person in your area to provide Rescue Backup. That is someone who is able to collect the dog in case of emergency and keep him or her safe until Semper Fidelis Domus is able to make alternative arrangements. No dog will be adopted without the proper Homecheck and without Rescue Backup. If you with to propose someone for that role, please give their name and contact detailes below. PLEASE READ AND SIGN UNDERNEATH PLEASE BE AWARE THAT DOGS CAN CAUSE DAMAGE AND MAY NEED REMINDING OF HOUSE TRAINING. REACHING OUT IS NOT RESPOSIBLE FOR ANY DAMAGE CAUSED. Please note that some of the dogs will take weeks, even months, to settle in. Please read Eli s Guide on the Advice Page. SEMPER FIDELIS DOMUS SHELTER IS NOT RESPONSIBLE FOR ANY OUTCOMES WHERE INCORRECT INFORMATION HAS BEEN GIVEN ON THIS FORM OR ANY OTHER FORM, INCLUDING CONTRACTS. SUBMISSION OF THIS FORM FOR CONSIDERATION AS AN ADOPTER/FOSTER HOME CONSTITUTES ACCEPTANCE AND UNDERSTANDING OF ALL TERMS AND CONDITIONS THEREIN SIGNED BY: (APPLICANT) PRINT NAME: ADDRESS FOR RETURNING BY POST THE HORSE AND GROOM EAST WOODLANDS NEAR FROME SOMERSET UK BA11 5LY 6