First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
County*
Email*
Home Phone
Work Phone x
Cell Phone
Alt Email
Please enter the name and age of the person who will have the primary responsibility for the care of the dog.*
Name(s) and age(s) of those who reside in the home*
Do you often have other people visiting your home* Choose one: Yes No
Do you have Grandchildren visiting in your home* Choose one: Yes No
Do you have other children* Choose one: Yes No
Is everyone in the residence and family agreeable to adopting a dachshund* Choose one: Yes No
Have your children been exposed to dachshunds Choose one: Yes No N/A
Have you applied with any other rescue group at this time such as All Texas Dachshund Rescue, Central Texas Dachshund Rescue or Dachshund Rescue of Houston* Choose one: Yes No
Have you adopted from DDRTX in the past?* Choose one: Yes No
Are you willing to teach young children the proper care and treatment of dachshunds* Choose one: Yes No
Are you willing to teach everyone in your home, and all visitors, the proper care and treatment of a dachshund* Choose one: Yes No
Are you willing to always monitor young children with the dachshund? Even a dachshund that has proven reliable around young children* Choose one: Yes No
Are you willing to read books about dachshunds and discuss the dachshund breed with your Veterinarian, Animal Behaviorist, and other Professionals in order to better understand the dachshund breed and their special characteristics* Choose one: Yes No
Are you willing to take the dog to a Veterinarian at least once a year for a physical exam, shots, and heartworm checks* Choose one: Yes No
Are you willing to take the dog to a Veterinarian when ill* Choose one: Yes No
Are you willing to welcome the dog into your family as a permanent member* Choose one: Yes No
Will you return the dog ONLY to a Diamond Dachshund Rescue of Texas representative if you decide that he/she cannot be a member of your family* Choose one: Yes No
Will you keep the dog on Heartworm preventative every month* Choose one: Yes No
Are you aware of the financial obligation involved in owning a pet* Choose one: Yes No
Are you aware of the needs, time and patience involved with rescue dachshunds* Choose one: Yes No
Who will care for the dog and where will the dog be kept*
How do you feel about keeping dogs outside*
Have you ever owned a dog* Choose one: Yes No
If so, what happened to it, what caused their death
Have you ever owned a dachshund* Choose one: Yes No
If so, what happened to it
Why do you want to adopt a rescued dachshund at this time*
If you suddenly had to relocate or had other drastic lifestyle changes that made it hard to keep your new pet, what would you do with him/her*
What will you do if your pet is destructive (ie: chews, digs, barks excessively, etc.)*
Do you currently have any other pets* Choose one: Yes No
Please list the name, species, breed, gender, and age of each
Are you aware that most purebred dachshunds are NOT the best choice for families with very young children* Choose one: Yes No
Are you willing to adopt a dachshund that is older Choose one: Yes No
Are you willing to adopt a dachshund that is abused Choose one: Yes No
Are you willing to adopt a dachshund that is not reliable with children Choose one: Yes No
Are you willing to adopt a dachshund that is physically handicapped Choose one: Yes No
Are you willing to adopt a dachshund that requires medication Choose one: Yes No
Are you willing to adopt a dachshund that requires housetraining Choose one: Yes No
What type of residence* Choose one: Rent Own
If renting, is landlord agreeable to having a rescued dachshund Choose one: Yes No N/A
Do you have a yard* Choose one: Yes No
Is the yard fenced* Choose one: Yes No N/A
What type of fence Choose one: N/A Wood Privacy Wood Basket Weave Chain Link Stone Brick Wrought Iron
How do you feel about chaining or tying a dog*
Are there stairs in your residence* Choose one: Yes No
Where will the dog be kept while you are away from home*
How many hours will the dog be left at home alone*
Where will the dog sleep*
Who will care for the dog while you work*
Would you be willing to take the dog for obedience training if needed* Choose one: Yes No
Are you familiar with the necessary annual shots, as well as, heartworm testing and preventative* Choose one: Yes No
Do you plan on continuing with these procedures* Choose one: Yes No
Are you familiar with flea and tick treatment and preventative* Choose one: Yes No
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 you, that suits your needs.*
Please list preference: (please indicate if you do not have a preference in any category) COLOR
Age
Gender Choose one: Male Female No Preference
Size Choose one: Miniature Tweenie Standard No Preference
Coat Choose all that apply: Smooth Wirehair Longhair No Preference
Is there a specific dog you are interested in from our website or that you met at an event we attended (please understand that we cannot hold dogs for people and there may be applications in ahead of yours for a specific dog)
Please provide the following information for your Veterinarian (please note: your vet will be contacted as part of our reference check process. If you use more than one veterinarian, please let us know as we will need to contact all of them.) Name:*
Clinic Name*
Address
Address (cont.)
State
Zip
Phone Number*
I hereby authorize the release of information from my Veterinarian to Diamond Dachshund Rescue of Texas Representatives* Choose one: True False
Please enter your initials in the space provided below indicating you agree to the release of Veterinarian information*
If you rent, we require this information to verify requirements with your Landlord - Name
Apartment Name
City
Phone Number
Fax
Email
Due to the current COVID situation, we are unable to conduct our home visit in person. We are holding Virtual Home Visits via videoconference which allows us to meet the family as well as see the home, yard, and fence to make sure they are all safe for pets. Do you agree to conduct a Virtual Home Visit?*
What type of device will be used to conduct the videoconference virtual home visit?* Choose one: Android Apple
WE DO CONTACT PERSONAL REFERENCES AS PART OF OUR REFERENCE CHECK PROCESS. THE FASTER YOUR REFERENCES RETURN OUR CALLS, THE FASTER YOUR APPLICATION GETS PROCESSED. Please provide the following contact information for a personal reference. Name:*
Please provide the following contact information for a personal reference (not a relative): Name*
Please tell us how you found our website* Choose one: Friend/Family DDRTX Representative Another Website Yahoo! Search Google Search Dog Pile Search Ask Jeeves Search Other Search Engine Don't Know Other