Basset's Name (if known): Name Marital Status: Age: Street Address City State Zip Phone Number Email Occupation Do you own or rent your home? If you rent, we need a signed letter from your landlord agreeing to allow you to have a dog in your house/apartment. No exceptions.
Do you have a Fenced Yard? Have you ever owned a basset before?
Are you aware that some bassets may have medical conditions? Medical conditions common to the breed are: fatty cysts, back/disk problems, glaucoma & bloat.
Despite being known as small dogs, the average basset weighs approx. 35lbs to 60lbs and vary in colors such as Tri, mahogany/white, Lemon/white, red/white, etc...
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? **Please note the name that is on the vet's account in parentheses beside the vet's name, if the account is not under the potential adopter's name !** Vet's Address City State Zip Phone Number Email
Are there other animals in the household? If yes, please list what they are, their sex, age, and how many. Are they spayed/neutered? Are they vaccinated? 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 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:
All Dogs.............................................$150.00 ($155.00 if paying by Pay Pal)Pairs Adopted Together.....................$200.00 ($205.00 if paying by Pay Pal)Basset Mixes and 'Wannabes'...........$75.00 ($80.00 if paying by Pay Pal)
Please check the appropriate box:
(Each statement requires an answer)
I will seek immediate veterinary help 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 such as Interceptor. I Agree I Disagree
If for any reason I can no longer keep my dog, he/she can only be returned to 4 The Hounds Basset Rescue. I will not put him/her in a shelter. I will not give him/her to anyone else without the approval of 4 the Hounds 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 4 The Hounds 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; the adoption fee will not be refunded. I agree I Disagree
My typed initials and name represent my legal signature. I Agree I Disagree If you disagree, you may print off an adoption form or write to Gail Sutton at ges39@aol.com and one will be sent to you. Initials of Basset Adopter: Printed Name of Adopter: