Adoption Application

Ozark Mountain Basset Rescue, Inc.

Thank you for your interest in adopting a Basset through Ozark Mountain Basset Rescue, Inc. (OMBR). The first step of the process is to fill out and submit an application. You may use this online application or the printable version to mail in. You may also want to print out the application once you have filled it in to keep for your own records. You will be contacted once your application has been received and reviewed. Please remember some important points:  Adoptions will not happen overnight. OMBR's only interest is in the safety and well-being of the Bassets in our care. We will take every step possible to ensure these Bassets are adopted to loving forever homes. We take our time in processing each applicant to make sure we find suitable homes for our Bassets as well as suitable Bassets for each applicant.

Please make sure all information is complete and accurate. Completely filling out the application will help avoid any delays in processing!

Once you have completed and submitted this form PLEASE email Katherine Mason at kat@ombr.org to alert her of the incoming application! Print out the confirmation page and keep for your own records.

Thank you! We look forward to working with you!

If you experience any problems with the online application please contact the webmaster at webmaster@ombr.org for assistance.


Dog Information

Which dog are you interested in, if known:

Age limitation of a basset you would be interested in:

Contact Information

Today's Date:      Name:

Marital Status: Spouses Name:

Occupation: Email Address:

Address: City: State Zip

Home Phone: Work Phone: Cell Phone:

Best Time to Call: Referred by:


Household Information

I live in a(n): House Apartment Mobile Home Condo/Townhome

which I own rent.

If you rent, do you have permission from your landlord to have a dog? Yes No

Landlord's Name: Landlord's Phone Number:

Landlord's Address: City State Zip

How long have you been at this residence?

Do you have a fenced yard? Yes No

If no, do you agree to keep the dog leashed at all times? Yes No

If no, what arrangements have you made for the dog's exercise and toilet needs?

Number of Adults in the Household: Are there children in the home? Yes No

If yes, how many children and what are their ages?

Which family member will be responsible for the care of your dog?

Is anyone home during the day? Yes No

At night? Yes No

On average, how long will the dog be home alone during the day?

Is anone in your household allergic to dogs? Yes No


Pet Information

Have you ever owned a pet before? Yes No

Have you ever owned a basset hound before? Yes No

Have you ever owned a rescue dog before? Yes No

How do other members of the family feel about adopting a basset?

Why do you want to adopt a basset?

Please supply us with some information about your current pets:

Pet #1

Type/Breed
      Age:
      Sex: M/F
      Spayed/Neutered: Y/N
      Owned how long:
      Dominant/Submissive:
      Behavior with other dogs? Explain

Pet #2  

Type/Breed:
      Age:
      Sex: M/F
      Spayed/Neutered: Y/N
      Owned how long:
      Dominant/Submissive:
      Behavior with other dogs? Explain

Pet #3  

Type/Breed:
      Age:
      Sex: M/F
      Spayed/Neutered: Y/N
      Owned how long:
      Dominant/Submissive:
      Behavior with other dogs? Explain

Pet #4  

Type/Breed:
      Age:
      Sex: M/F
      Spayed/Neutered: Y/N
      Owned how long:
      Dominant/Submissive:
      Behavior with other dogs? Explain

Do you have a regular veterinarian? Yes No

Vet's Name:          Phone Number

Address: City: State: Zip:

How much to you expect to spend on vet expenses in a year?

What pet names are on your vet's records?

If you do not have a regular vet, please provide us with 2 personal references:

Name: Phone: Relationship:

Name: Phone: Relationship:

Have you ever given up a pet? Yes No

Why?

I am interested in a Male Female

Any specific color? Yes No If yes, please state preference:

Where will the dog be kept during the day? Night?

Are you willing to crate train your basset? Yes No

Are you willing to housetrain the dog? Yes No Method Used:

Will you be training your dog? Yes No

Are you willing to train a "problem dog"? Yes No

Which problems are you willing to take on:
          chewing: Yes No  

          housebreaking: Yes No

          barking: Yes No
          possible abuse issues: Yes No
           socialization issues: Yes No

I will work with Ozark Mountain Basset Rescue, Inc. if a problem with the dog arises. Yes No

Are you willing to have a home visit prior to the adoption? Yes No

Are you willing to take responsibility for the dog for it's lifetime? Yes No


Volunteer Interests:

Would you be interested in volunteering for OMBR? Yes No

     Please check areas of interest:

       Fostering: Long term   Short term
       Fund raising
       Transportation/Relays
       Veterinary Services
       Special Projects
       Other: Please Specify:

         


I understand the Basset Hound

Will require an annual heartworm text and be place on monthly preventative medication. Yes No

Will require an annual physical exam and vaccinations. Yes No

Will need time (approximately 4-6 weeks) to adjust to his new home. Yes No

Will need periodic grooming, dental care, ear cleaning and nail trims. Yes No

Will need plenty of exercise. Yes No

Will shed year round.Yes No

Is a scent hound, will roam if on a scent, and therefore MUST NEVER BE OFFLEASH IN AN UNSECURED AREA. Yes No

Will have an average cost in the first year to "outfit" your dog (crate, collars, leashes, dog bed, bowls, toys, food and vet care) that could exceed $500. Yes No


 

All of the information I have provided on this application is, to the best of my knowledge, true and complete. I understand that falsifying answers on this application, or at any other time during the application process disqualifies me from adoption.

I am aware that submitting this application does not gurarantee that I will receive approval to adopt a dog from Ozark Mountain Basset Resue, Inc.

By submitting this application, I hereby authorize Ozark Mountain Basset Rescue, Inc. to access my veterinary records.