Name(s)
Email
Address
City, State, Zip
Home Phone
Work Phone(s)
Cell Phone(s)
Own       Rent
Landlord Contact Number
Years at this Residence

Names and ages of children

Others living with you

Employer name and number

Supervisor's name

Position and number of years with this employer

Please provide three personal references.

Vet's name and number

Groomer's name and number

Dog sitter/kennel/day care name and number

Trainer's name and number

Rescues you've worked with

Do you have a fenced yard? yes no

Size?

Type of fence?

Height?

How many hours are you away from home each day?

Where will the dog stay when you're not home?

How will you exercise him/her?

How will you transport him/her?

Where will s/he sleep?

Are you willing to follow holistic guidelines for his/her care? yes no

What will you feed him/her?

How often will you vaccinate?

What is your vet's current vaccination requirement?
(Rabies, Distemper, Parvo, Parainfluenza, Adenovirus, Hepatitis,
Leptospirosis, Bordatella, Giardia, Lyme Disease, Etc.)

Are you willing to switch veterinarians if your current vet is not willing to comply with our vaccination requirements? yes no

Many trainers, kennels, groomers, etc. require vaccinations which we believe are dangerous and unnecessary. Are you willing to research alternatives to those you may currently use? yes no

What will you use for flea prevention?

What will you use for heartworm prevention?

Tell me about the trainining methods that you use.

How do you discipline your animals?

Please tell me about other animals currently living with you.

Do any of these animals have health or behavioral issues?
If so, please describe what they are and how you've managed them.

Please tell me about other animals who have shared your life.

How have you dealt with illness and injuries in your animals?

Have you ever had a companion animal euthanized for anything other than sever health problems or old age?
yes no

Have you ever needed to find a new home for an animal in you care?
If so, please describe the circumstances.

Who are you applying to adopt?

Why are you interested in this particular dog?

Describe your "perfect" dog.

Describe any health issues or behaviors which would be problematic for you.

The Spay/Neuter Incentive Project and Sanctuary
"snips" at Pawsitive Energy
Marysville, Ohio
Minimum Standards of Care

Dogs who are adopted before they are spayed/neutered must be altered within two months of adoption, or the animal will be reclaimed by snips, and any fees involved in the adoption of the animal will be forfeited. Our adoption fee is $250.

snips/Pawsitive Energy reserves the right to inspect the condition of this animal at any time, and may reclaim the dog if he is found to be living in conditions not in accordance with the Minimum Standards of Care.

If you at any time are unable to keep this animal, he must be returned to snips/Pawsitive Energy.

The following list constitutes the criteria for the Minimum Standards of Care for animals adopted from snips/Pawsitive Energy. These standards must be adhered to from the date of adoption and for as long as the dog is in your care.

Shelter:
This dog is to be kept in the house. If it is necessary for him to be housed outside for short periods of time, he shall have access to a shelter which will protect him from the elements at all times. The shelter must be constructed so that it can be maintained free from extremes of both heat and cold.

Containment and Security:
This dog must not be allowed to roam free without supervision. He may not be tied out. If the dog is to be kept outdoors unsupervised for any period of time, he must be in an appropriately fenced-in area, where he will be safe from other animals, people and motor vehicles. The area shall be kept free of items that may cause injury or illness to the animal, including machinery, chemicals, contaminated feed and accumulated fecal matter. Adequate shade must be provided.

This dog must wear a current ID tag at all times. He should also wear a properly fitted collar at all times. We recommend the use of a choke-proof collar for safety. This dog will never be left wearing a choke or prong collar when he is unattended.

The dog must never be left in a car when temperatures exceed 65 degrees Fahrenheit. She must never be transported unrestrained in the back of a pickup truck or similar vehicle. (We strongly recommend the use of Easy Rider dog restraints or crates whenever this dog is in a motor vehicle.)

When not supervised, this dog should be confined to a crate or other dog-proofed, restricted area for his safety during the first few week's adjustment to his new home.

Exercise and Training:
This dog must be allowed adequate exercise. For the first several months in your home, this dog must only be exercised off lead in a fenced area. After he has been living in your home for a period of six months, if the dog is 100% reliable on recall, he may be exercised under close supervision in an open, unfenced area removed from streets and traffic and other hazards. If she is not 100% reliable on recall, she may only be released in a secure, fenced area. Greyhounds and greyhound crosses may never be exercised in an unfenced area.

Training methods using 100% positive reinforcement are required.

Feeding and Nutrition:
This dog must be provided with a diet based on a recognized, commercially manufactured or home prepared diet approved by a veterinarian or animal nutritionist and appropriate for the animal and her stage of life, activity level, etc. We require that she be fed a food made with human grade ingredients, with no chemical preservatives and no by-products. The dog should be fed twice daily and shall not be overfed or underfed. Every attempt must be made to maintain her at a weight appropriate for her age and size. Food supplements must be limited to those food items considered safe for an animal of this age and size. Processed foods designed for human consumption (such as candy, cookies, chocolate, etc.) shall not be fed to this animal at any time. The food should be fed in an appropriate dish or bowl (preferably stainless steel) which is to be kept clean at all times.

Water:
This dog must have access to fresh, cool, clean, pure drinking water at all times.

Medical Care and Maintenance:
A licensed vet familiar with small domestic animals must examine this animal on an annual basis.

At a minimum, this examination should include an evaluation of general health; vaccinations should be minimal (no more than every three years).

The existence of hair, skin or intestinal parasites, dental or eye problems should be noted and treated.

Nails must be kept trimmed, and teeth must be kept clean.

In case of any injury or illness, the services of a licensed vet shall be obtained without delay. All reasonable treatment shall be afforded a sick or injured animal. Medical decisions should be based on what is in the best interest of the animal and on the animal's quality of life following the contemplated course of treatment.

Should euthanasia become necessary, a licensed veterinarian shall accomplish it in a humane and painless manner, and then only after all prudent and reasonable medical treatment has been afforded the animal. If euthanasia seems necessary, you are urged to contact snips/Pawsitive Energy or another reputable sanctuary or shelter. Many seemingly hopeless medical cases are able to live out long, healthy lives with the proper veterinary intervention.

It is expected that you will provide your animal with love, affection, and some form of companionship on a daily basis. Dogs are sociable creatures by nature, and require the companionship of people and other animals for good mental and emotional health. Isolating your companion animal from the contact of others is a serious form of abuse.

We strongly suggest that you have at least one other dog to provide this dog with company of the same species.

If this is not a viable option, you must ensure that your dog receives a great deal of love and attention on a continual basis and socialization with other dogs of similar size and disposition as often as possible.

Remember, this dog needs two parts exercise, one part discipline and one part affection, in that order. Providing him with clear and consistent rules, guidelines and limitations will give him a sense of security in his new pack, and will minimize or eliminate any potential behavioral issues.

If for any reason you are ever unable to care for or no longer want this dog, s/he must be immediately returned to snips/Pawsitive Energy.

I agree to comply with these standards.
Signed:
Date: