Tidewater Bichon Frise Rescue

Happy Tails

Tidewater Bichon
Frise Rescue
P O Box 8084
Suffolk,VA 23438
757-986-BARK (2275)
whitedogresq@yahoo.com

Adoption Application

Thank you for your interest in a rescued Bichon!

The Bichon thrives and flourishes when he can be around his "family". This heightened sense of people orientation and people dependence, coupled with their housetraining difficulties makes it imperative that we place only in homes where there is an adult home the majority of the day. We do not adopt to families with children under the age of 8. We do not ship dogs, we adopt only within a 100 miles of the Hampton Roads area of Virginia. In order to help pay for veterinary care for the dogs in our program, our adoption fee is $250, $300 for pups under 1 year old.

Bichon Rescue is dedicated to the care of abandoned and homeless dogs and to placing them in loving homes with compatible owners. An incorrect placement may mean the dog, once again, has to adjust to a new family and a new home

The accompanying application is the first step in our adoption process. We must receive a completed questionnaire from you before we can discuss specific adoption opportunities. Therefore, please take a few minutes to fill out this adoption application form. It will help us to provide a "good match" for you and the dog.

For a list of Frequently asked questions, click here for our FAQ or you may click here to read our Adoption Policies,

Please DO NOT use your "enter" key while filling out this application. By using the "enter" key, your application will be submitted immediately at that point, whether it is completed or not. We do not process incomplete applications. To move from answer to answer use your mouse or tab key only.
Please submit the completed application by clicking "Submit" at the bottom of this page.

Once we receive your application questionnaire, we will review it and inform you of your adoption candidacy. Remember, it is not first come, first served; rather, best match to best possible home.

Basic Adoption Information
Name:		Age:
Occupation:
Name:		Age:
Occupation:
Address:		City:
State:		Zip:
Telephone Number:		FAX Number:
Email:
I have children, ages
Name, age and relationship of other people in the home:
How were you referred to us?
Is this your first dog?

Place Of Residence
I live in a:		Other:
My neighborhood is:
Do you rent or own your place of residence?
If renting, Landlord's name and phone #:
Do you have a fenced yard?		Type of fence:
If you do not have a fully enclosed, secure fence how will you exercise the dog ?
Who will supervise these outdoor activities? (This includes all times that the dog is outdoors)

Why A Bichon?
Why do you want a Bichon?
Please explain briefly why you believe you would provide a great home for a rescued Bichon:
What are your expectations/concerns about getting a rescued Bichon?

Preferences
Gender:		Would you consider the opposite sex?
I prefer a dog: (Bichons usually live 15 -16 yrs.)
Energy level: (Check all that describe)	Athletic/High energy Outdoorsy Lap dog Playful Very affectionate Quiet Couch potato Other:
Why do you want a dog? (Choose all that apply)	companion watch dog gift to breed playmate for current dog for child replace previous dog Other:
What type of interactions do you want to have with a dog?		What weight would you prefer?
Would you consider one 19 to 25 lbs?		Would you consider a Bichon blend?
Would you consider a dog that may have "special needs" (elderly, blind, deaf, ongoing medical treatment, 3 legs, etc)?		Would you consider adopting a pair of dogs that cannot be split up?
Does everyone in the family want a dog?		Would you consider a dog that is NOT housetrained?

Bichon Experience & Your New Dog
Have you or your spouse owned a Bichon before?		How long ago?
Times/hours adult home on weekdays:
Times/hours adult home on weekends:
In what part of the house will the dog stay during the day while you are at home?
In what part of the house will the dog stay during the day while you are gone?
In what part of the house will the dog stay at night?
What bad habits will you NOT be able to tolerate: (Choose all that apply)	Jumping up Barking Pulling on the leash Not housebroken Separation anxiety Chewing Digging Play biting Rough Play Other
Under what circumstances would you have to give up your pet? (Choose all that apply)	Moving New baby Divorce Pet Behavior Explain: Pet's Health Other: None
MOST RESCUED BICHONS ARE NOT HOUSETRAINED. What method(s) would you use to housetrain?
What other types of professional training are you prepared to provide? (Check all that apply)	Obedience Agility Other
Who will care for this dog when you go on vacation?
How much will you exercise the dog?
Who will be primarily responsible for this dog?
What are your needs/desires in a dog?
How many hours will this pet be left alone during the day?
Do you have any of the following? (Check all that apply)	dog house outdoor kennel run runner /pulley system adequate outdoor shelter Other
Will someone be home to feed the dog twice a day?
How much do you think it will cost to take care of this dog each year? (consider the cost of vet, grooming, food, licensing, etc.)
If you intend to use a crate how long will the dog be crated during the day?		At night?
If you are no longer able to care for the dog, who would take over the care?

Pet Ownership
What animals do you now have at your residence?
Type:		Breed:
	Age Sex Spayed/neutered?
Type:		Breed:
	Age Sex Spayed/neutered?
Type:		Breed:
	Age Sex Spayed/neutered?
Type:		Breed:
	Age Sex Spayed/neutered?
Type:		Breed:
	Age Sex Spayed/neutered?
Where are these animals kept?
What other animals have you had in the past 5 years?
Where are they now? (if your pets have passed away, please give us the age and cause of death)
What kinds of problems if any, did you have with them?
Name and phone number of your current veterinarian
List names and phone number of other veterinarians that you have used in the past five years.
May we contact your vet
Name of groomer:		Phone Number:

Additional Information
Do you have a disability or condition that would affect the kind/type of dog you would require?	If "yes" explain:
Are there any other expectations or requirements that the new dog must meet?
What hobbies, activities do you participate in that you would expect to include the dog? (hiking, camping, reading, watching TV, etc.)

Home Visit And Agreement
Which days of the week are best for a home visit?
EVERYONE IN THE FAMILY, INCLUDING OTHER PETS, MUST BE PRESENT FOR THE FIRST VISIT, NO EXCEPTIONS.

I/ We hereby authorize through submission of this form, any veterinarian named above to release any information and records concerning my past or present care of animals to Robin Gray/ Tidewater Bichon Frise Rescue and I do hereby agree to hold harmless and indemnify said veterinarian for providing such information. I / We understand that shall the adoption not work out, for any reason, the dog will not be given away, sold or put in a shelter but will be returned to Robin Gray / Tidewater Bichon Frise Rescue. I further understand that completing this application does not guarantee that a dog will be placed with me. I certify by submission of this form that I have never been convicted of any violation of any ordinance or statute enacted pursuant to cruelty, neglect or abandonment of an animal. I will be asked to sign this document at the first home visit. I understand that owning a dog is a commitment for the dog's lifetime and if I adopt a dog from Tidewater Bichon Frise Rescue, I am willing to make a 15 year commitment.
Name(s) of applicant(s):
Date: