Always remember that rescue operations have found homes for dogs with circumstances that met even the most limited of situations.

       Note that there is an adoption fee that varies depending on the cost of the following:
- Shelter break out fee
- Rabies vaccination
- DHLPPC annual booster shots
- Heartworm check (or treatment)
- Heartworm preventative
- Spay/neuter charge (if age appropriate)

ADOPTION FEES ARE DUE AT THE ADOPTION DAY WHEN YOU TAKE YOUR DOG. YOU MAY PAY US WITH CASH, CASHIER'S CHECK, PAYPAL (accessed thru our website), OR PERSONAL CHECKS (please let us know in advance). ALL CHECKS ARE TO MADE OUT TO: NEDRC -OR- Northeast Dog Rescue Connection, Inc. Please contact your vet to authorize release of information to NEDRC.



Pre-Adoption Form - Please fill in all information completely.
Your full name:
Your email address:(e.g.:you@aol.com)
Your phone number (including area code):
Fax Number:
Address:                                                                          Country:
City:                                                            State:                         Zip Code:
Date:
Name of Dog(s) Desired:
Have you owned dogs or any other animals in the past? yes/no
Where are these animals now? Please elaborate!



For whom are you adopting?
Name and ages of humans residing in the home:
Does anyone residing in the home have allegies?
If yes, please describe allergy and trigger(s):



Do you often have other people visiting your home? yes/no
Grandchildren? yes/no
Other children? yes/no
Is everyone in the residence and family agreeable to adopting a rescued dog? yes/no
Have your children been exposed to rescued dog? yes/no
Are you willing to teach everyone in your home, and all visitors, the proper care and treatment of a rescued dog?yes/no.
Are you willing to teach young children the proper care and treatment of this breed? yes/no
Are you willing to always monitor young children with this breed? Even a rescued dog that has proven reliable ar young children? yes/no
Are you also willing to:
-Take the dog to a veterinarian at least once a year for a physical exam, shots, and heartworm check? yes/no
-Take the dog to a veterinarian when ill? yes/no
-Welcome the dog into your family as a permanent member? yes/no
-Return the dog ONLY to a NEDRC representative if you decide that he/she cannot be a member of your family yes/no
-Maintain heartworm preventative medications throughout the dog's life? yes/no
-Do everything in your power, and with the help of your veterinarian, and lor other professionals to ensure that the has a long, healthy life? yes/no

Have you given careful consideration to the following:
Financial obligations of responsible pet ownership? (Often a minimum of $300.00 year) yes/no
Special needs and time and patience involved with rescue animals? yes/no

Who will care for the dog and where will the dog be kept?
Are you willing to adopt a dog that is:
Older? yes/no
Abused? yes/no
Not reliable with children? yes/no
Physically handicapped? yes/no
Requires medication? yes/no
Requires housetraining? yes/no
 
Type of residence:
own or rent:
If renting, is landlord agreeable to you having a rescued dog?
Do you have a yard? yes/no
Is it fenced? yes/no
If not fenced, do you have an exercise program ready for the dog?
Are there stairs in your residence?
Where will the dog be kept during the day?
How many hours a day will the dog be left at home alone?
Where will the dog sleep?
Who will take care of the dog while you work?
Would you be willing to take the dog for obedience training. if needed?
Are you familiar with the necessary shots (annual) as well as heartworm testing and preventative?
Are you familiar with flea and tick treatment and preventative?
What do you intend to feed the dog?

Please list all of the reasons you can think of that a dog could not become a permanent member of your family. Please be honest with yourself. There are always very legitimate reasons and this will help us place a dog with that fits your home.



Please list preferences:
(please indicate if you do not have a preference in any of the categories)
Color:
Age:
Sex:
Size:(smallish to larger):
Coat: (normal. longhair):
Please list the name, phone number and address :
1. Veterinarian:



2. Landlord if applicable:




3. References: Please give names and phone #'s {NOTE:   Please notify these people, giving them permission to share information with a representative of NorthEast Dog Rescue Connection}








The information provided in this application is true to the best of my knowledge as of the date on this application. typing your name below, you signify that you have filed this application, and understand all that is contained within it.

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