This form is set for delivery to the adoption committee
and will be forwarded to the representative in your area or to the foster
representative of the dog you are inquiring about. CCDR gets an enormous
amount of inquiries and will respond to your submittal in as soon as possible.
If you have any specific questions you may email: email@example.com
Thank you CCDR
Do you often have other people visiting your home?
Is everyone in the residence and family agreeable to adopting a dachshund?
Have your children (if applicable) been exposed to dachshunds?
Yes No Not
Are you willing to teach everyone in your home, and all visitors, the
proper care and treatment of a dachshund?
Are you willing to teach young children the proper care and treatment
of a dachshund?
Are you willing to always monitor young children with the dachshund?
Even a dachshund that has proven reliable with young children?
Are you willing to:
Read books about dachshunds, and discuss the dachshund breed with your
veterinarian, animal behaviorists, and other professionals in order to
better understand the dachshund breed and their special characteristics?
Take the dog to a veterinarian at least once a year for a physical exam,
shots, and heartworm check?
Take the dog to a veterinarian when ill?
Welcome the dog into your family as a permanent member?
Return the dog ONLY to Coast to Coast Dachshund Rescue if you decide
that he/she cannot be a member of you family?
Maintain heartworm preventative medications throughout the dog's life?
Do everything within your power, and with the help of your veterinarian,
and/or other professionals to ensure that the dog has a long, healthy life?
Have you given careful consideration to all of the following:
Financial obligations of responsible pet ownership?
Special needs and time and patience involved with rescue dachshunds?
Who will care for the dog, and where will the dog be kept?
Have you ever owned a dog?
Have you ever owned a DACHSHUND?
Why do you want to adopt a rescued dachshund at this time?
Do you currently own any other pets?
If yes, then please provide name, species, breed and age of each:
If you have other dogs and cats, are they all spayed or neutered?
Coast to Coast Dachshund Rescue has a very strict spay/neuter policy
requirement. This policy can be located at http://www.c2cdr.org/spay_neuter_policy.html
If you have an unaltered dog or cat, please explain in detail why the
animal has not been altered.
If you have previously owned dogs, what happened to those no longer
living with you?
What do you know about the characteristics of the dachshund breed?
Are you familiar with the unique personality of a dachshund?
Are you aware that purebred dachshunds can have a predisposition to
back problems, weight gain, and house training problems?
Are you aware that purebred dachshunds are not the best choice for families
with very young children?
Are you willing to adopt a dachshund that is:
If you checked yes above, what age are you willing to consider?:
10 years 7
to 10 years 5
to 7 years
Not reliable with children?
Requires ongoing medication other than heartworm preventative?
Requires continued house training?
Would you consider adopting a pair of dachshunds in the case of dogs
that should not be separated and need to be placed together?
Type of residence:
House Condominium Apartment
Own or Rent?
If renting, is landlord agreeable to you having a rescued dachshund?
Yes No Not
Do you have a yard?
If not fenced, do you have an exercise program for the dog?
**If you do not have a fenced yard, how would you exercise your dog?
This is a required answer if you do not have a fenced yard.
Are there stairs in your residence?
Where will the dog be kept during the day?
How many hours a day will the dog be left at home alone?
Where will the dog sleep?
Who will take care of the dog while you work?
Would you be willing to take the dog for obedience training if needed?
Are you familiar with the necessary shots as well as heartworm testing
Are you familiar with flea and tick treatment and prevention?
What do you intend to feed the dog?
If needed, how will you housebreak the dog?
Please list preferences:
lbs and over at 12 months of age)
lbs and under at 12 months of age)
mini between 11 and 20 lbs)
Gender: Male Female No
Preferred age range:
Veterinarian's name, Clinic Name, Address, Phone
number and email address