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Select Page
Online Adoption Form (TEST)
Step
1
of
6
- Basic Information
16%
Do you have children in the home under the age of 8? We do not adopt to households with children under 8.
Yes
No
We're sorry, Doberman Rescue will not adopt to a home with children under 8 years of age.
Do you have a fenced yard? Fencing must be physical fencing: chain link, wood, wrought iron or vinyl and has to be at least 4' high. Invisible fencing does not constitute fencing for the purposes of this question.
Yes
No
We're sorry, Doberman Rescue requires a fenced in yard.
Do you keep your current dogs on monthly heartworm preventative (please note that we will check with your vet to make sure there is a history of purchasing or having it scripted out by them online).
Yes
No
We're sorry, Doberman Rescue requires proof of heartworm prevention to adopt one of our dogs.
Your Name
*
First
Last
Occupation
Spouses Name
First
Last
Spouse's Occupation
Email
*
Phone
*
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
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Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
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New Mexico
New York
North Carolina
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Northern Mariana Islands
Ohio
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Puerto Rico
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Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
What is the best time to contact you?
How did you hear about us?
What Doberman are you interested in adopting?
Are you married, single or have roommates?
Married
Single
Roomates
* NOTE: WE DO NOT ADOPT TO HOUSEHOLDS WITH CHILDREN UNDER THE AGE OF 8.
List the names and ages of ALL people living in household including children, roommates, etc.
Who will be the primary caretaker of the dog?
Do all occupants want a Doberman?
YES
NO
Do you have an active lifestyle or more sedentary?
Is your family active in such a way it would include a Doberman?
YES
NO
Please Describe:
Do you have frequent visitors to your home?
YES
NO
Are there adults and children or animals with which the new dog must get acquainted?
YES
NO
If so please list who, relation, and ages.
Please list the addresses you have been at (including current) for the past two years and length of time lived there.
What type of housing do you have?
House
Apartment
Mobile Home
Do you own or rent your residence? (If you rent, a letter of permission from your landlord allowing Dobermans will need to be provided.)
Own
Rent
Do you have: (* = required)
Dog Run
Dog House
Dog Door
Fenced Yard*
Type of Fence
Chain link
Vinyl
Wood
Composite
Wrought Iron
Fence height
3 feet
4 feet
5 feet
6 feet
Yard Size (sq. ft.)
If you have no fence how will the dog be contained, exercised and taken to the bathroom?
Have you ever been convicted of animal cruelty/neglect or received a citation from local authorities on your animals? (* = required)
*
Yes
No
If yes, please explain.
Other pets that you have now:
Pet Names, Breeds, Age, and Sex
Are those pets Spayed/Neutered?
YES
NO
Are those pets Licensed?
YES
NO
Are those pets Vaccinated?
YES
NO
Are those pets up to date on Heartworm Preventative?
YES
NO
If you currently have a dog, does it get along with other dogs?
YES
NO
Have you ever bred a litter?
YES
NO
If so, why?
If you have a dog, what type of food do you use?
Are cats Indoor or Outdoor? Or don't have cats.
Indoor
Outdoor
Don't have any cats
Are cats used to dogs?
Yes
No
Where are current pets kept during the day?
Dogs that you have previously owned in the last 5 years:
Breed, Sex, Spayed/Neutered, Years Owned
If any animals owned currently or previously were not spayed or neutered please specify reason why.
Please specify why each animal is no longer with you (given away or deceased) as well as details of how, when and why.
Please provide the full name, address and phone number of your veterinarian. We do check vet records.
Do you know the temperament & characteristics of the Doberman?
YES
NO
Have you ever owned a Doberman?
YES
NO
Where will the Doberman be kept during the day?
Where will the Doberman be kept at night?
How many hours will the dog be alone per day?
Where will the Doberman be when you are gone?
Do you have the time and patience to train your new dog and help it to adjust to its new home and family?
YES
NO
Are you willing to allow one to two months for a proper adjustment?
YES
NO
Will you crate train your new dog?
YES
NO
Will you attend obedience class(es)?
YES
NO
Have you ever been to obedience class before?
YES
NO
If so, Where and when?
Please explain why you are interested in a rescued Doberman? (Enter reasons for wanting to own a rescued Doberman here)
Are you willing to commit to owning this dog for a LIFETIME (up to 12 or more years at times)?
YES
NO
Do you have a backup plan for any major life changes that may occur in that time?
YES
NO
Please elaborate and include what your plans for the dog would be should (for example) a move be required for military or any other reason.
What would, in your opinion, be a reason to not keep a dog?
May a DRON representative visit your home? (* = required)
*
YES
NO
Do you have any questions about the Doberman breed we can answer? (Enter questions about Dobermans here)
We are always in need of foster homes for our Dobermans. Would you be willing to foster a needy Doberman if it is compatible with your home?
YES
NO
I have answered all questions above truthfully to the best of my knowledge and understand that Doberman Rescue of Nebraska reserves the right to refuse adoption for any reason.
*
Name and Date (your name entered here will be considered your signature)
Please Note: A fenced yard is required. *We do not place our rescue dogs in homes with very young children (under the age of 8 years). We set these limitations, not because of aggression issues with our dogs, but because Dobermans are generally large, active dogs and can easily knock down, run over or easily trip a small child, causing a serious fall. We reserve the right to refuse adoption for any reason.
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