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Western Missouri Basset Rescue , Inc.

Adoption Application & Contract

Please fill in every blank. If a question does not apply, answer N/A

If you would prefer to print out the application and mail the completed form to us, please click here.

Basset's Name:      Today's Date:
Name
Marital Status: Age:
Street Address
City
State Zip Phone Number
Email
Occupation:
Do you own or rent your home?
If you rent, can you provide proof of Landlord's approval to have pets?

Do you have a Fenced Yard?
Have you ever owned a basset before?

Are you aware that bassets are prone to certain medical conditions?
     Medical conditions common to the breed are: fatty cysts, back/disk problems, glaucoma & bloat.

Are you aware that the average basset weighs approx. 40lbs to 65lbs?

Have you ever put a dog to sleep?
     If Yes, please tell us why:

Why do you want a basset hound?

Where will the basset be kept while you are out for the day or at work?

Where will the basset stay when you are on vacation or out of town?

Do you agree that this basset will be an indoor pet and will sleep inside the house?

Are all the adults in the household in agreement on adopting this dog?

Who is your Veterinarian?
Vet's Address
City
State
Zip
Phone Number
Email


Are there other pets in the household?
If yes, please list what they are, their sex, age, disposition, and how many.
Are they spayed/neutered?
Are they current on their vaccinations?
Can we verify this with your vet?
What kind of heartworm preventative do you use or plan to use?
Do you understand the necessity of heartworm preventatives?
If not, have you evern know of a dog that had HEARTWORMS and the severity of the treatment needed to cure the disease?

Are there Children in the Household?

If yes, how many and what are their ages?

Please list two references we can call or email:
Reference #1:
Name:
Street :
City:   State:   Zip:
Phone Number:
Email:

Reference #2:
Name:
Street :
City:   State:   Zip:
Phone Number
Email:

_________________________________________________

Are you interested in volunteering to help with basset rescue? If so, which areas are of interest to you?

Fostering
      Short term?      Long term?
Transportation?
Fund Raising?
Special Projects?
Veterinary Services?
Other?
          Please Specify

_________________________________________________

Western Missouri Basset Rescue, Inc.

ADOPTION CONTRACT



The goal of Western Missouri Basset Rescue, Inc. is to find kind and loving homes for basset hounds. We are a NON-profit organization and get our operating monies from adoption fees and donations.

If, at ANYTIME during your adoption, you need advice, help with medical problems, training issues, etc., please feel free to call Chris at 816-353-5643, or Margaret at 816-853-1634. We are happy to answer any question or to help with any problem you may be having adjusting to your new basset.

Please bear in mind that most basset hounds in rescue have been abandoned, neglected or even abused in some way, and it may take some time, even weeks for them to understand your routine and what you expect of them. There will also be accidents even from the adults, so please exercise patience. Also, remember puppies chew and bassets can be puppy-like for up to 3 years!

If you have smaller children in the household, PLEASE teach them to never bother the basset during mealtimes or while he/she has a chew toy. Some dogs have food and toy issues and children should be supervised during these times.

The adoption fees are as follows:


All Dogs.............................................$150.00
Puppies.............................................$200.00

Included in the adoption fee: vaccinations, spaying/neutering, and all costs to make the basset healthy for adoption.

Please check the appropriate box:

(Each statement requires an answer)

I will seek immediate veterinary assistance should my dog become ill or injured.
I Agree I Disagree

I will have my dog seen by a veterinarian on an annual basis for it's yearly physical examination and vaccinations.
I Agree I Disagree

I will protect my dog from heartworm by administering an accepted heartworm preventative as recommended by my veterinarian.
I Agree I Disagree

If for any reason I can no longer keep my dog, he/she can only be returned to Western Missouri Basset Rescue, Inc.. I will not put him/her in a shelter. I will not give him/her to anyone else without the approval of Western Missouri Basset Rescue, Inc.
I Agree I Disagree

My dog will never be left alone outside when we are not home or go out unleashed in an area that is not fenced.
I Agree I Disagree

If for any reason Western Missouri Basset Rescue, Inc. finds that I am in violation of any of the terms of this contract, you have the right to remove the dog from my home, and the adoption fee will be forfeited.
I agree I Disagree

My typed name represent my legal signature.
I Agree I Disagree

If you disagree, you may print off an adoption form or write to Chris Bly at chris@wmbri.org and one will be sent to you.


Printed Name of Adopter:

Once you've hit "Send," please call us at 816-353-5643
and let us know an app is on the way so we can be on the lookout for it.

Please print this form for your records.