Western Missouri Basset Rescue, Inc.

Adoption Application

and Contract

Basset's Name: _____________________________________    Date: ________________

Name: _________________________________ Phone Number: _______________ Email: ____________________

Address: _________________ City: ______________________

State: __________________________ Zip: ________________

Occupation: __________________________________________

Do you rent or own your home? ___________ If you rent, can you provide proof of approval to have a pet from your landlord?

Do you have a fenced yard? ________ If not, do you understand that bassets are scent dogs and cannot be expected to stay close to home and must be on a lead at all times? _______

Have you ever owned a basset before? ________ If not, are you aware of their signature habits such as drooling, shedding, and body odor? Not all bassets have any or all of the above. ______

Are you aware that some bassets may have 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. _______________________________

Where will the basset be kept during the day while you are out 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? ______________

Where will the basset sleep?________________________________

Are all the adults in the home in agreement on adopting this dog? ______

Page 2

Who is your Veterinarian?__________________________________________

Address: ________________________________________________________

City: ______________________________ State: __________ Zip __________

Email: __________________ Phone #: _____________

Are there other animals in the household?_______ If yes, please list what they are, their sex, age, disposition, and how many._____________________________________________________________________

Are they vaccinated, spayed/neutered and 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 such medications? ___________

If not, have you ever know of a dog that has had HEARTWORMS and the severity of the treatment needed to cure the disease? _____

Are there children in the household? If yes, how many and ages: ___________________________________________________________________

Please list 2 references with phone number or email address that we can contact: ___________________________________________________________________

Are you interested in volunteering to help with basset rescue? If so, please check the following areas where you may be able to assist us: Fostering______ Short Term? _____ Long Term? _____ Transportation? ______ Fund Raising? ______ Special Projects? _____ Veterinary Services? _____ Other? _____ Please Specify _____________________________________________

Signature of person responsible for Adoption:______________________

Date of Application and Signature:__________________

Print name of person signing above:______________________________






Western Missouri Basset Rescue, Inc., 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

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

1. I will keep and protect this dog throughout it's lifetime. If at any time I find I cannot properly care for this dog, I will contact Western Missouri Basset Rescue, Inc. so you can make arrangements to take the dog back, or approve another home I may have found.
I agree____ I disagree____

2. I will seek immediate veterinary help should my dog become ill or injured.
I Agree______ I Disagree_____

3. 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_____

4. I will protect my dog from heartworm by administering an accepted heartworm preventative such as Interceptor.

I Agree_____ I Disagree_____

Signature of basset adopter______________________________________

Please mail completed application and contract to:

Western Missouri Basset Rescue, Inc.
P.O. Box 9434
Raytown, MO 64133