How long at your present job *:
Have you ever been charged with animal or child abuse?
If Yes - When:
Type of Residence *
If 'Other' please list here:
If 'Other' please list here:
Are you planning to move in the near future?
If 'Yes' please list location here:
May we visit your residence? *
Do You Have A Fenced Yard? *
Type of fence:
Attached to House?
If you do not have a fence, how will the dog be exercised?
Are There Other Adults In The Residence *
If yes, enter the number:
Are there children in the home? *
If yes, enter their name, gender and age
PLEASE TELL US WHAT TYPE OF DOBERMAN YOU WOULD LIKE TO ADOPT:
Age Preference (check all that apply)
Under 6 Months
6 Months To 1 Year
1 Year To 3 Years
3 Years To 5 Years
Over 5 Years
Did you see any specific Dobermans on the
site that you were interested in adopting? If so please enter their name(s) in order of preference.
Why do you want a Doberman?
What qualities do you most desire in a Doberman?
(Quiet & Reserved ... Active ... For Agility Training)
Other Dogs / Animals
Have you or your spouse owned a Doberman before?
If yes, how long ago?
What happened to it?
Are there other animals currently in the home?
If yes, list type or breed, age, sex, neutered or not and where they were kept for each animal
What other animals have you owned in the past 5 years?
If you had dogs, what happened to them? What kind of problems did you have with them?
Have you ever given away, sold or surrendered a dog before and why? *
If yes, list the reasons below.
Do your neighbors have pets?
If Yes, please describe:
Are they aware that you will be adopting a Doberman?
If yes, what was their reaction:
List the veterinary clinic you currently use:
NOTE: Please verify that this is the correct address and phone number for the veterinarian's office.
Wrong information will delay the application process!
Names of Pets Seen By Veterinarian *
List the Name & Breed - 1 per line
List other veterinarians that you have used in the past.
Please include Address and Phone Numbers
Pets Medical HISTORY:
Are your Pets current on all vaccinations, Rabies shots, heartworm and fecal tests? *
Do you vaccinate for Distemper/Parvo?
Do you vaccinate for Bordatella?
Do you vaccinate for Rabies?
Do you test for heart worms?
Do you have fecal tests performed?
Are your pets current on heartworm preventative *?
If yes, list the brand
How long will dog be alone each day? *
How much time a day would be spent playing/training dog?
Where will dog be housed during most of the day? *
Where will dog be housed during the night? *
Feelings about crate use and do you own one? *
Dog food to be fed (please be specific):
Who will care for dog when you are out of town?
List any Humane Societies, Organizations, Breed or Training Clubs you are Associated With
Would you be willing to take the adopted dog to obedience classes?
How would you handle a destructive dog?
How would you handle a dog digging?
How would you handle a dog chewing?
How would you handle a dog that needs house training?
How would you handle a dog that jumps on people?
How did you hear about Doberman Rescue of the Triad?
Are you currently registered with any other Doberman Rescues?
If Yes, list please list the Agencies:
Terms and Conditions
Doberman Rescue of the Triad reserves the right to refuse adoption of any Doberman in its program for any reason.
I AGREE THAT THE DOBERMAN I ADOPT FROM DRT WILL NOT BE USED FOR BREEDING PURPOSES, AND WILL BE ALTERED ACCORDING TO THE ADOPTION CONTRACT.
I AGREE THAT IF I CANNOT KEEP THE DOBERMAN FOR ANY REASON, I WILL RETURN IT TO DRT IMMEDIATELY, FORFEITING ANY ADOPTION FEE AND/OR DONATION GIVEN TO DRT.
DRT CANNOT HOLD DOGS INDEFINITELY. A DEPOSIT WILL BE REQUIRED, OR THE DOG WILL BE MADE AVAILABLE FOR THE NEXT ADOPTER. IF THE DOG IS NOT PICKED UP BY THE ADOPTER WITHIN THE AGREED-UPON-TIME, ADOPTER FORFEITS DEPOSIT AND ALL CLAIMS TO DOG.
I HAVE READ THIS ADOPTION APPLICATION IN ITS ENTIRETY AND HAVE UNDERSTOOD AND ANSWERED EACH QUESTION TO THE BEST OF MY ABILITY AND AGREE TO THE TERMS AND CONDITIONS.