DISCLAIMER - There are no guarantees made, expressed or implied, that any person requesting completing an application to adopt a dog through Lhasa Happy Homes Rescue, Inc. (LHH), or posted on LHH's Website,Petfinder and/or 1800SaveAPet will automatically be approved. All adoptions are subject to acceptance based on a review process that includes, but is not limited to reference check(s), in-depth interview and home visit.  The decision to place any dog(s) in an adoptive home is determined by the review of such information, and adoption applications may be denied for any reason. LHH reserves the right to refuse to adopt to anyone without disclosing the reason(s) and to make decisions regarding the final disposition of any rescued dog in its care, whether in, or being placed in, a foster, adoptive home or other facility, confidential. Additionally, LHH reserves the right to post dogs on its website and/or Petfinder or 1800SaveAPet that under the auspices of other rescue group and LHH may have no jurisdiction over how these dogs are placed.
  
Finally, as a general rule, LHH does not adopt the Lhasa Apso breed to families with children under 8 yrs old.  In some cases, we will adopt an owner surrendered dog or a dog whose background we are familiar with to a child 5yrs old +.  **LHASA HAPPY HOMES DOES NOT SHIP DOGS OUT OF STATE UNDER ANY CIRCUMSTANCES and only in special cases will adopt out of state.  In those rare but approved instances, primary adopter would be required to be present at LHH adoption event to receive dog.
RESCUE ADOPTION APPLICATION
This questionnaire has been designed to aid us in determining if potential adoption homes are prepared to assume the type of responsible ownership we endeavor to assure for our rescued animals.  Our goal is to be thorough; not invasive.  Please answer all questions honestly and feel free to add your own comments.  Please keep in mind that providing false information will result in the nullification of this application.  PLEASE ANSWER ALL QUESTIONS. Thank you.
IF A QUESTION DOES NOT APPLY PLEASE WRITE N/A, AS ALL FIELDS MUST BE FILLED.
ABOUT YOU
(Person applying must be 21 yrs of age and the primary individual responsible for this animal)
Pet Intrested In:  Today's Date: 
Full Name:   
Phone (Work):
Ext.:
Email:   
Phone (Home):
Phone (Cell): 
Best Time to Call:
Which Number:
Applicant's age: 
Street Address:
City/State/Zip  
Number of adults in household:  
Name of spouse/significant other/roommate:  Spouse's Age: 
Relationship to you:      *Explain:   
Your Occupation:  Spouses Occupation: 
If this relationship were to change, with whom would the dog(s) remain?:
Who will be primarily responsible for the dog(s) care?
Do you have children? 
Do they live with you? 
Have they been around dog(s)? 
List their ages: 
If you do not have children now, are you planning a family in the future?
If yes, when?
If you have children, are you planning to have more children in the future?
If yes, when?
What are your reasons for adopting a dog(s)?
*Gift or Other/Explain: 
Would you consider a dog with :  Special Needs
Behavior issues
Abused
Senior
Blind/Deaf
What are the qualities you are looking for in a dog(s)?
Are you familiar with the characteristics/temperament of this breed?
If yes, how so?
Does anyone in the household smoke?
Are you prepared to pay $40+ every 4-6 wks to groom your dog(s)?
In your selection, what is your preference?
Breed:
Sex:
Age range:
Color:
My ideal pet:  
What concerns, if any, do you have about adopting?  

HOME INFORMATION

 
  I consent to a home check in the event my application is approved.
Type of Dwelling:
Pets Allowed? 
Years at Residence:  Do you have a Landlord/HOA? 

If you have one, may we contact your Landlord/HOA?

 

 

If no, please explain:
Landlord/Owner/HOA (Name, Phone #)
Where will the dog(s) stay during the day:
Other, explain:
If the dog is indoors only, what access does he/she have to outside?
How many hours a day will the dog(s) be left outside?
What outside space is available for the dog(s)?
If fenced yard, what type?
*Other: 
Height: 
Do you have a grassy area?
Do you have a pool? Is it fenced?
Other access areas for dog: 
*Other: 
Will the dog(s) be tied up? 
Where will the dog sleep: 
*Other/Explain:
Any areas where the dog(s) will not be allowed?
Are you planning a move in the next six months? 
Please explain:
If you ever had to move, would your dog(s) move with you?
PAST/PRESENT PET HISTORY
Have you had a dog(s) in the past 10 years ?  
When?  (Please explain)   
Do you now own a dog(s)?   Number of dog(s) in household: 
Other animals in home:*
*If so, where are they housed?
History of dog guardianship/ownership (please list each dog separately, list most recent dog first):

Breed

Sex

Spay/Nutered?

Where did you
get the dog from?

Age of dog
when you got it?

Still

Own Dog?

If no longer own,

what happened to the dog?

Present age of

dog or age at
death if applicable?

Please provide
detailed explanation if
no longer have dog?
 
 
Have your dog(s) been vaccinated?
Will you provide annual vaccinations?
If no or depends, please explain:
Will you provide necessary medical care?
If no or depends, please explain:
Veterinarian's name, phone number, address:  (current or most recent)
We must have this reference to process your application.
May Lhasa Happy Homes contact your veterinarian?
If no, please explain:
How many hours per day will your dog(s) be alone?
Explain:
Any provisions to let the dog(s) out during the day?
How many times will the dog(s) be walked each day?
How will your dog(s) spend the day?
Do you have a friend or relative* who would care for the dog(s) if you became incapable of caring for him/her for an extended period of time?
Please provide name, relationship to you and their phone number:

Lhasa Happy Homes reserves the right to approve individuals, with no bias, for the protection of the dog(s).

Will your dog(s) be allowed on the furniture?
Will you become frustrated if your dog(s) is not housebroken?
How do you plan on housebreaking your dog(s)**?

Please understand that even dogs that are housebroken will go through an adjustment period.

What would make you consider giving up your dog(s):  (check all that apply)

 







 






 

What would you do with your dog(s) if you could not keep for any reason(s) listed above?
*Explain other:
If your dog(s) needed acute medical attention for an illness or emergency care, are you prepared to handle the expenses?
If your dog developed an illness and required monthly medication, up to what amount would you be comfortable in spending? (Please check one response)

 *Other amount, please explain:

 

Would you be willing to adopt a dog that required monthly medication that costs under $50 a month?
If you currently have a dog, what brand of food are you feeding him/her?
If a higher quality food was recommended but is more expensive, would you be willing to change foods?
If no, please explain:
Have you ever trained a dog in obedience?
Would you agree to take this dog(s) to obedience school?
If the dog(s) becomes destructive, what would you do?
When your dog(s) disobeys, how do you reprimand?
Would you ever use a newspaper or object to reprimand your dog(s) to stop bad behavior?
What would you do if your dog starting snapping or bit at you or a family member?
*Other: 
Will you be able to live with fur on your furniture, stains on your rugs, a warm body on your bed, who may be destructive at times?
What would happen to this dog(s) if family situation changed (divorce, relocation, death)? Please answer this question in detail.
Have you ever given away/sold or released an animal to a shelter or rescue group?
If yes, why? 
Have you ever been denied adoption by a shelter or other rescue or humane group? 
If so by whom? 
Do you travel a lot?
Where will your dog(s) stay when you are traveling or on vacation?
*Explain:
How did you hear about this group?
Please let us know who referred you so that we can thank them! 
Please briefly describe your lifestyle: (active, social, homebodies, etc.)
How is your general health (health issues)?
Adopters over the age of 70 are required to have a co-adopter in case of accident or death. If this applies to you, who would be your co adopter: (name, address, phone number and relationship to adopter)
Please give three additional references. These may be friends, co-workers and relatives. Please give name, relationship to you, email address and phone number.
Additional pertinent information:
 
Additional pets information: 
 

ADOPTIONS REQUIRE A HOME CHECK and/or delivery of the dog(s). This does not include any special transport or shipping where applicable.

 

PLEASE MAKE A COPY OF THE COMPLETED APPLICATION AND BRING IT WITH YOU TO ADOPTIONS.
FOR BEST PRINT RESULTS, PLEASE SET PAGE ORIENTATION TO LANDSCAPE UNDER PRINTER PROPERTIES. 

 

PLEASE MAKE SURE YOU HAVE ANSWERED ALL THE QUESTIONS TO THE BEST OF YOUR ABILITY,

AS THIS WILL ONLY HELP US IN DETERMINING THE RIGHT FIT FOR YOU.

THANK YOU FOR TAKING THE TIME TO COMPLETE THIS APPLICATION. OUR GOAL IS NOT TO BE INVASIVE BUT TO MATCH THE BEST POSSIBLE HOME FOR EACH ANIMAL.
PLEASE CLICK SUBMIT BUTTON ONLY ONCE!
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This page was updated on :1/11/2007
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Lhasa Happy Homes Rescue, Inc.
Website Last updated 01-Aug-2014 Contact our webmaster webmaster@lhasahappyhomes.org