Dog Adoption Application

All applications encouraged! HART promotes adoptions that are in the best interest of both the dog and potential adopter. HART does not adopt dogs on a first come first serve basis. All applications will be screened by HART to determine the most suitable match for both you and the animal.

You may submit one application for multiple dogs.

Thank you for your interest in adoption!

Unfortunately our online dog application requires Javascript, which does not appear to be either supported or enabled on your browser. Many features on the HART website require Javascript to be enabled in order to use the full functionality. See your browser's help for information on enabling Javascript.

If you cannot or do not want to enable Javascript, you can still download a copy of our dog application in PDF format to print out and bring to one of our adoption events.

Thank you for your interest in adoption!

Unfortunately our online dog application does not support your version of Microsoft Internet Explorer. HART recommends updating to the latest version of Internet Explorer or the latest version of Mozilla Firefox.

If you cannot or do not want to upgrade your internet browser, you can still download a copy of our dog application in PDF format to print out and bring to one of our adoption events.

Tell Us About Yourself & Your Home

Your Dog's Enviroment

Find Your Perfect Dog

Previous Pet History

Warning!

You are about to remove all of the pet history information from this part of the application. Do you really want to remove it?

Remove Pet History

Keep Pet History

Almost Done

Do you have children?

Yes No

Names and ages of children:

Do you plan to have children in the future?

Yes No

Please list members of household, relationship to you, and their ages*:

*Roommate, child, husband, mother, etc.

Do you own or rent your home?

Own Rent

Does lease allow pets?

Yes No

Do you have a fenced yard?

Yes No

Type*:

*Chainlink, privacy, etc.

Height:

Are you willing to fence?

Yes No

Do you have a doggy door?

Yes No

Do you plan to have a doggy door?

Yes No

Area around your home:

Rural Suburban Urban

Type of home:

Single Family
Townhouse

Apartment
Condo

Length of time living at this location:

List company and length of employment*:

*List for each adult in household

Plans to move or change employment in the near future?

Continue to Part 2 >>

Each day, your HART dog would be left alone?

0-5 Hours
9-12 Hours

6-8 Hours
12+ Hours

If you are currently working from home due to COVID-19 restrictions, how will your hours at home change after the COVID-19 restrictions end*?

*Please understand that we have always adopted dogs to people who work outside the home and that has not changed.

When you are not home, your HART dog would be kept?

Outside
Crated
Basement

Enclosed Area
Free Roam of House
Other

Please explain:

When you are home, your HART dog would be kept?

Outside
Crated
Basement

Enclosed Area
Free Roam of House
Other

Please explain:

On leash, when & where will you exercise the dog:

Off leash, where will the dog be allowed to exercise:

How much time do you realistically have each day to exercise or play with your HART dog?

Each year, you are away from home on vacation/travel?

0-2 Weeks
5-6 Weeks

3-4 Weeks
7+ Weeks

While on vacation/travel, who will care for your dog?

What do you foresee as normal dog problems?

Have you dealt with behavioral issues with other pets*?

Yes No

*Housebreaking, chewing, separation anxiety, etc.

Please explain:

How will you encourage/reinforce appropriate behavior?

How will you prevent/manage inappropriate behavior?

Have you ever taken a formal obedience class?

Yes No

Will you to take your HART dog to obedience training?

Yes No

If you are not home, will your HART dog be outside unattended?

Sometimes
Never

In Nice Weather
Other

Please explain:

If you have to move, what will you do with your HART dog?

Find New Home
Take on Move
Other

Take to Local Shelter
Return to HART

Please explain:

<< Return to Part 1

Continue to Part 3 >>

How long have you looked for a dog?

Why do you want a dog?

Protection
Friend/Companion

For Children
Other

Please explain:

Why did you choose Dustin Chi?

Are you interested in other HART dogs?

Yes No

Names of other HART dogs:

Who will be the primary or sole caretaker of the dog?

What age most appeals to you?

Puppy
Adult

Young Adult
Senior

What size dog most appeals to you?

Tiny
Medium

Small
Large

Do you or your home have a weight limit?

Yes No

Weight limit:

Is your home subject to breed restrictions?

Yes No

Which breeds are restricted?

What aspects of a dog are most important to you?

Appearance
Obedience
Agility
Adaptability

Low Maintenance
Companionship
GamePlayer

What activity level most appeals to you?

High Medium Low

What type of coat most appeals to you?

Long Short No Preference

Is someone in your family willing to brush your HART dog often?

Yes No

How much do you think it will cost to have your HART dog groomed?

Is anyone in your family allergic to dander or pet hair?

Yes No

Please explain:

Where will your HART dog sleep?

How much do you think it costs ANNUALLY to own a dog?

Will you give your HART dog Heartworm Preventative every month?

Yes No

What causes Heartworm in dogs?

What would cause you to consider giving your dog back to HART? Check any that you think may apply.

If my work schedule changed such that I no longer have sufficient time for the dog.
If I have children in the future and I no longer have sufficient time for the dog.
If other changed circumstances prohibit me from having sufficient time for the dog.
If someone in the household becomes allergic to the dog.
If I become ill and can no longer take care of the dog.
If I lose my job and can no longer take care of the dog.
If I divorce or separate from my spouse or partner.
If my new significant other or spouse does not like the dog.
If the dog sheds excessively.
If the dog is not housebroken.
If the dog becomes aggressive.
Other

Please explain:

<< Return to Part 2

Continue to Part 4 >>

Have you owned a dog, cat, or other pet?

Yes No

You can list up to six (6) pets.

Add A Pet

Reset Fields
Remove Pet

Pet name:

Pet breed:

Gender:

Male Female

Was pet spayed or neutered?

Yes No

Where did you get the pet?

Primary vet name & phone:

Number of years with pet:

Current age of pet:

Is pet still with your family?

Yes No

What happened to the pet*?

*If given up, please give approximate date.

Date and cause of death:

Add Next Pet

Reset Fields
Remove Pet

Pet name:

Pet breed:

Gender:

Male Female

Was pet spayed or neutered?

Yes No

Where did you get the pet?

Primary vet name & phone:

Number of years with pet:

Current age of pet:

Is pet still with your family?

Yes No

What happened to the pet*?

*If given up, please give approximate date.

Date and cause of death:

Add Next Pet

Reset Fields
Remove Pet

Pet name:

Pet breed:

Gender:

Male Female

Was pet spayed or neutered?

Yes No

Where did you get the pet?

Primary vet name & phone:

Number of years with pet:

Current age of pet:

Is pet still with your family?

Yes No

What happened to the pet*?

*If given up, please give approximate date.

Date and cause of death:

Add Next Pet

Reset Fields
Remove Pet

Pet name:

Pet breed:

Gender:

Male Female

Was pet spayed or neutered?

Yes No

Where did you get the pet?

Primary vet name & phone:

Number of years with pet:

Current age of pet:

Is pet still with your family?

Yes No

What happened to the pet*?

*If given up, please give approximate date.

Date and cause of death:

Add Next Pet

Reset Fields
Remove Pet

Pet name:

Pet breed:

Gender:

Male Female

Was pet spayed or neutered?

Yes No

Where did you get the pet?

Primary vet name & phone:

Number of years with pet:

Current age of pet:

Is pet still with your family?

Yes No

What happened to the pet*?

*If given up, please give approximate date.

Date and cause of death:

Add Next Pet

Reset Fields
Remove Pet

Pet name:

Pet breed:

Gender:

Male Female

Was pet spayed or neutered?

Yes No

Where did you get the pet?

Primary vet name & phone:

Number of years with pet:

Current age of pet:

Is pet still with your family?

Yes No

What happened to the pet*?

*If given up, please give approximate date.

Date and cause of death:

If you have owned more pets than listed here, please inform the HART representative that contacts you.

What heartworm medication have you used in the past?

Have you incurred extraordinary veterinary expenses?

Yes No

What was the cause of the extraordinary expense?

What was the approximate cost of the treatment?

Have you ever had to give up a pet for any reason?

Yes No

What happened to the pet?

Found New Home
Other

Took to Shelter

Please explain:

<< Return to Part 3

Continue to Part 5 >>

Will you permit a home visit by a HART Representative?

Yes No

Do you authorize a vet check by a HART Representative?

Yes No

How did you hear about HART?

Newspaper
Friend
Internet

Petco
Petsmart
Other

Please explain:

Referred By:

Please enter your contact information

Name:

Address:

City:

State:

ZIP:

Home Phone:

Work Phone:

Cell Phone:

Email Address:

Please enter your email address Please enter a valid email address

Confirm Email Address:

The email addresses must match.

Please understand that HART promotes adoptions that are in the best interest of both the dog and potential adopter. All applications will be screened by HART to determine the most suitable match for both you and the animal.

HART does not adopt dogs on a first come first serve basis.

After you click "Submit", you will be taken to a confirmation page where you can print a copy of your submitted application. You will also receive an automated email copy of your application.

In addition, your application will be forwarded to a HART representative who will contact you within three business days.

<< Return to Part 4