Adoption Form

Please note:  Before starting to fill this out,  contact your vet's office giving them permission to release information to us regarding your pets. You will need to give us the name of the person you spoke with later in the application.



I am interested in:

About You

First Name:
Last Name:
Primary Phone:
-
Primary Phone Type:
Alternate Phone:
-
Alternate Phone Type:
Preferred time to be contacted:
Email:
Street Address:
City:
State/Province:
Zip/Postal Code:
Age:
Occupation:

2nd Applicant (if any) Information

2nd Applicant's First Name:
2nd Applicant's Last Name:
2nd Applicant's Phone:
-
2nd Applicant's Phone Type:
2nd Applicant's Email:
2nd Applicant's Age:
2nd Applicant's Occupation:

 

Total number of adults in the household?
Are any members of the household allergic to pet dander?
Do either of your jobs require frequent out-of-town travel?
Is either applicant a student?
Is either applicant in the military?
Is either applicant subject to relocation?
Have all members of the household agreed to adopt a Weimaraner?
Who will be the primary caretaker of the Weimaraner?
Weimaraners are a very demanding breed and require a great deal of time and attention. Explain why you think your home would be suitable for fostering/adopting a senior Weimaraner and why you want a Weimaraner.
 
Is there a particular dog you are interested in?
 

About Your Home

Number of children under 18 living with you:
Ages of children living with you:
Do children under the age of 10 ever visit your home? (neighbors, grandkids, etc.)
 
Please check one. I/We live in a:
Do you own or lease/rent?
If you rent or lease, name of landlord or property manager:
Landlord's/property manager's phone #:
-
How long have you been at this address?

Your Veterinarian

You must contact your vet's office giving them permission to release information to us regarding your pets. We need the name of the person you spoke with. YOUR APPLICATION WILL NOT BE PROCESSED IF LEFT BLANK. Thank you.

Veterinary Clinic Name:
Clinic Phone Number:
-
Name of person at vet's office with whom you spoke:
Vet Street Address:
Vet City
Vet State/Province
 

About Your Current Pets

Name of current pet #1:
Type of current pet #1 (dog, cat, bird, etc.):
Breed of current pet #1 (if any):
Gender of current pet #1:
Is current pet #1 spayed/neutered?
Age of current pet #1:
Is current pet #1 (check all that apply):
Where is current pet #1 kept? Check all that apply:
 
Name of current pet #2:
Type of current pet #2 (dog, cat, bird, etc.):
Breed of current pet #2 (if any):
Gender of current pet #2:
Is current pet #2 spayed/neutered?
Age of current pet #2:
Is current pet #2 (check all that apply):
Where is current pet #2 kept? Check all that apply:
Do you currently have more than two pets?
Will your current pets accept a new dog?
Are all of your current pets up-to-date on vet care, vaccines (or titer tests) and heartworm testing/preventative?
Are all of your pets in current compliance with local, city or township licensing/registration requirements?

About Your Former Pets (in the last five years but no longer with you)

Name of former pet #1:
Former pet #1 type (dog, cat, bird, etc.):
Former pet #1 breed (if any):
Gender of former pet #1:
Was former pet #1 spayed/neutered?
Age of former pet #1 when lost:
Where was former pet #1 kept? Check all that apply:
Why is former pet #1 no longer with you? (death, given away, lost, taken to shelter, etc.)
Year of occurrence:
Name of former pet #2:
Former pet #2 type (dog, cat, bird, etc.):
Former pet #2 breed (if any):
Gender of former pet #2:
Was former pet #2 spayed/neutered?
Age of former pet #2 when lost:
Where was former pet #2 kept? Check all that apply:
Why is former pet #2 no longer with you? (death, given away, lost, taken to shelter, etc.)
Year this happened:
Have you had more than two pets in the last five years who are no longer with you?
Have you ever taken a pet to a shelter/rescue or had a pet run away?
Have you ever owned a Weimaraner?
If yes, how recently?
What was your experience like with your Weim(s)?
How did you hear about Senior Moments Weimaraners?
Do you understand that your fostered/adopted Weimaraner is to be an indoor dog only?
Considering your lifestyle, what Weimaraner energy level would be most compatible?
What traits in a dog are MOST important to you? Please check all that apply:
What traits will you NOT tolerate?
Do you agree to return your fostered/adopted dog to Senior Moments Weimaraners should you be unable to keep them for any reason?
On average, how many days a week will your fostered/adopted Weimaraner be left alone at home (without humans)?
How many hours during a typical day will your dog be left alone (without humans)?
Where will your fostered/adopted dog stay when you're not home?
Where will your fostered/adopted dog be when you are at home?
Where will your fostered/adopted dog sleep at night?
When you are on vacation, where will your Weimaraner be? (You may choose more than one.)

About our Home Visit

The home visit will take place at a convenient time when all members of your family are home. Will you allow a SMW volunteer to visit you and your family in your home?
If a home visit is not possible due to your location, timing or some other circumstance, SMW may allow a virtual (digital) picture tour of your home and environment. If necessary, do you have the ability to provide digital photos of your home environment?

General Information

Do you understand and agree with the statements below?

I am aware that Senior Moments Weimaraners takes a holistic approach to veterinary care and, where legally possible, will have titer testing done to determine the protective level of Distemper and Parvo antibodies before automatically vaccinating. Most senior dogs have had multiple vaccines over their lifetime and over-vaccination has proven health risks. Rabies vaccines have been given without titer testing. I am aware that flea/tick prevention will have been accomplished using natural methods whenever possible rather than pesticide application on the Weim (exceptions initially made for dog with existing pests when entering the program).
I am aware that my fostered/adopted dog may require basic obedience training/manners, housebreaking and/or crate training and I am willing to use positive methods suggested by SMW or seek a local APDT (Association of Pet Dog Trainers) certified trainer. I agree to alert SMW or my local trainer as soon as I notice concerning behavioral issues.
I am aware that the period of adjustment into my household may be longer than anticipated for my fostered/adopted dog.
I am aware that SMW may have little to no information regarding the background of my fostered/adopted dog, but whatever they know will be passed along to me.
Would you be interested in joining our volunteer Joyride Team to transport senior Weims to safety in your area?

Thank you so much for taking the time to apply!  One of our volunteers will get back to you within 72 hours.

By clicking the Submit Button below I explicitly acknowledge that I am applying to foster/adopt this dog for myself. I am not applying to foster/adopt this dog for, or on behalf of another person or entity. I understand that any false statements made on my application, whether intentional or negligent, will indisputably cause the rescue harm in incurring costs to recover and repossess the dog from me. As such, I explicitly agree that should I make any false or misleading statements that the rescue relies on in placing a dog with me, the rescue will be entitled to recover liquidated damages in an amount no less than $2000 from me for pecuniary loss, opportunity cost and volunteer time.