Please check the required fields
Your application must be filled out COMPLETELY. If any fields are left blank, we will be unable to process it.
All our dogs are in southern foster homes, and will come to New England AFTER they are adopted. Please initial to indicate that you understand this, and would like to continue with the application process. Once your application has been received, you will speak with a rescue representative who will answer any questions you have about our adoption process and the dog you are interested in adopting!
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Name of the dog you are applying to adopt
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Your Name
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Your Address
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Your City, State and Zip
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Your Email Address
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Your home phone #
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Your cell phone #
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Your work number #
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Household Member 1 name (self):
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Household Member 1 age
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Household Member 1 occupation
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Household Member 2 name:
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Household Member 2 age:
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Household Member 2 occupation
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Household Member 3 name
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Household Member 3 age
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Household Member 3 occupation
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Household Member 4 name
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Household Member 4 age
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Household Member 4 occupation
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All our puppies have had three sets of DHLPP with Corona, the last one given within 2-3 days of the transport, this should protect them (there is never a 100% guarantee) from Distemper, Hepatitis, Leptospirosis, Parvo, Parainfluenza and Coronavirus, but they need two more boosters within the next 6 weeks, they have had a Bordetella vaccine to protect from Kennel Cough, but this does not prevent all strains of kennel cough any more than our flu vaccine protects against every strain of the flu- these puppies may never have been in a shelter, but if they were, they have been out of it for over 4-6 weeks. (initial)
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Please understand that puppies can often be very stressed from their transport and their change in living conditions, which can compromise their immune system and between the stress and the compromised immune system, it is very common for them to get Coccidia. This is an internal parasite that can only be treated, never cured (ALL dogs in the world have this, but it lies dormant until stress triggers the parasite to multiply- easily treated). We recommend SMZ-TMP (Bactrim) along with Metronidazole OR Albon along with Metronidazole for treatment. (initial)
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Another factor for puppies coming from the south to the north is climate change, again the stress from their transport and their change in living conditions, which can compromise their immune system, can lead to an Upper Respiratory Infection- again easily treated, but needs to be treated as soon as you notice a cough, sneeze, yucky eyes or a runny nose. We recommend 1) Baytril or 2) Doxycycline for the treatment of URIs. We do not have much luck with Amoxacillin and Clavamox, they seem to be more or less just a band-aid for URIs. (initial)
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The health certificate is signed by a vet AFTER a physical exam is performed and there is no sign of any health issues. Most health issues require an incubation period, if anyone (canine/human/feline) is incubating for any disease there is no way to recognize that until symptoms are presenting. (initial)
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It is our advice, due to climate change (south to northeast) and the possible stress from transport, that you bring your puppy (ies)/dog(s) to see your vet within three days of receiving him/her/them. (initial)
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Please copy and paste the following link to read about Common Health Issues: https://docs.google.com/document/d/1UCJbF8RVbUnMgh2t17rDMHGvZuviJNUkFEjeNBSn1BU/edit?hl=en# (initial)
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Do you rent or own your home
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Select
Rent
Own
If you rent, please provide a name and phone number for your landlord
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Who is your employer
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Are there any ordinances in your city that limit the amount of pets you can own?
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Select
Yes
No
If, so, please explain
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Is anyone in your home allergic to dogs
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Select
Yes
No
If you are applying for a German Shepherd: Are you aware that German Shepherds are active, very intelligent dogs who shed and require a lot of exercise and interaction with their family?
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Select
Yes
No
Have you owned a German Shepherd before?
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Select
Yes
No
Is your yard totally fenced in?
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Select
Yes
No
Where will the pet be kept during the day?
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Where will the pet be kept at night?
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How many adults live in your home?
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How many children live in your home?
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What are the ages of the children that live in your home?
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If no children live with you, do any visit regularly?
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Select
Yes
No
If so, what are their ages?
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How many hours at one stretch will the pet be without humans each day?
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Do you have a plan in place for vacation/away from home care for your pet?
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Select
Yes
No
What is that plan?
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Are you willing and able to provide pet care for the next ten or more years, including vet checks, vaccinations, boarding, medical care, indoor housing, etc.?
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Select
Yes
No
What will you do with your pet if you move?
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About what do you think pet care costs per year?
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We require all animals adopted from us to be spayed or neutered. Do you have any questions or reservations about this policy?
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Select
Yes
No
Please list all pets you have owned in the past ten years, how long you owned them, and what happened to them.
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Are your current pets (if applicable) on monthly heartworm prevention?
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Select
Yes
No
Are your current pets (if applicable) on vaccinations ?
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Select
Yes
No
If you have ever had a pet lost, disappear, or die at an early age, please provide details (dogs dying before age 10).
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Have you ever sold, given away, or surrendered a pet?
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Select
Yes
No
If yes, please describe the situation.
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How do you plan to exercise your dog?
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All dogs go through a major amount of stress when they leave the only home and family they have ever known, leave the only other animals they have ever known, get on a transport with over 100 dogs and people they have never seen and go into a new home with more strangers and more animals. It would be a lot for anyone- dog - cat - human to handle, some dogs acclimate more easily than others. It is important for all dogs to be given time to decompress and become aware that they are safe in their new surroundings. Please initial if you will you be willing to give them time to become accustomed to their new life:
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If it still does not work out please initial if will you be willing to foster while we find a new home.
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The animal may not be housebroken. Are you willing to take the time to work with the animal?
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Select
Yes
No
Name and phone number of past/current vet. NOTE: Please contact your vet after filling out this application and give him/her permission to talk to us about the care provided to your pets by them.
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Name of intended vet
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We may require a home visit as part of the application process. Will you comply?
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Select
Yes
No
Adoption fees vary per dog depending on the extent of vet care that was required. The individual adoption fee is posted on each dog's petfinder profile. The adoption fee goes to fund medical care, food and shelter for all of our animals, not merely the one you are applying for. Will you comply?
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Select
Yes
No
Have you applied to adopt from any other organization within the last 90 days?
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Select
Yes
No
If yes, what is the status of that application?
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Please provide a name and phone number for a personal reference who has been to your home and knows your family that would be willing to speak with a rescue representative on your behalf.
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Is there anything else we should know that would help us to understand your application?
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If approved are you ready to have your new dog or puppy arrive this Saturday?
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Select
Yes
No
Is your whole family in agreement with adopting this dog or puppy?
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Select
Yes
No
I understand this dog is in a southern foster home and will come to New England after adoption
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Select
Yes
No
I am comfortable with a long-distance, sight-unseen adoption if I can receive extensive information about the dog from the southern foster mom.
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Select
Yes
No
Once all your questions have been answered and your application has been approved, the dog you are adopting would need to come north on the next available transport, so the rescue can save another homeless dog. Do you have any questions about this?
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Select
Yes
No
I certify that I have carefully read and agree to all the provisions in this application. I have answered all questions as completely and honestly as possible. I understand that if it is discovered that I have falsified any information on this application, my application will be denied. Furthermore, if a dog from Loyal Heart Puppy Rescue has already been placed in my care, I will be required to immediately surrender the dog and will forfeit the adoption fee. By typing my name below and submitting this application, I am agreeing to all the aforementioned statements (initial)
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Applicant's Signature
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Date
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Security Code:
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