Bichons and Buddies wants to adopt Bichons, Bichon mixes and their canine buddies to a person or family that is/are willing to provide loving forever homes in which the dog’s health and well-being are taken care of responsibly.

We believe that adopting a dog is a commitment to the lifetime of your companion animal. We appreciate your willingness to complete this form so that we can learn more about you, your family and home environment. Because we take pet guardianship very seriously, we will carefully check your references. As a result, we hope that we will be able to place one of our dogs with you. Not every person who applies and desires to adopt a dog, however, will be qualified.

Please be brief with your answers to questions, as space is limited.

Thank You!

Your Information
*Your Name:
Name of Spouse:
*Address:
*City:
*State:
*Zip:
*Home Phone:
Work Phone:
Cell Phone:
*Your Email:
Names of all people living in your home and their relationship to you. If you have children living in or visiting your home, please also include their ages:
Your Home
*Type of dwelling you live in:	House Condo Apartment
*Do you own your home?	Yes No
If you rent, please include the name and address of your landlord:
*Do you have a fenced in yard?	Yes No
If no, please explain how you will handle toilet duties and excercise.
*Do you have a pool?	Yes No
If yes, is it fenced?	Yes No
Your Pets
*I agree that this animal is being adopted as a family pet, and will be given extensive house privileges; i.e. to sleep inside the house, to be allowed freedom of the house when the family is home, and NOT to be restricted to the yard.	Yes No
*Do you currently own another dog or pet?	Yes No
If so, please list names, breeds, and ages:
Is your pet spayed or neutered?	Yes No
*If you do not currently have a dog, have you owned one in the past?	Yes No
If yes, please tell us what happened to this dog. If it died, how old was it and what was the cause of its death?
*I will give this animal proper food, water, shelter and medical treatment as needed.
*I will immediately notify Bichons And Buddies if I change my address or telephone number.
Please provide the contact information for your vet:
Name:
Address:
Phone:
If you do not currently have a veterinarian, please provide the names and contact information for two personal references (outside of family members.)
*Do you give us permission to contact your vet?	Yes No
Your New Dog
*What is the name or type of dog you are looking to adopt?
*Do you have a gender preference?	Male Female Doesn't Matter
*What age Dog would you like to adopt?
*Does everyone in your family want this dog?	Yes No
*Who will be responsible for this dog?
*Will the pet be left alone for long periods of time?	Yes No
*On average, how many hours a day will the dog be left alone?
*If the pet will be left alone for long periods of time, where do you plan to keep the dog while you are gone?
*Where will the dog sleep?
Are you willing to accept the responsibility of housebreaking a dog if it is not already completely housebroken?
*Are you prepared to ensure that this dog receives regular veterinary care?	Yes No
*Are you aware that Bichons and Bichon mixes require regular grooming for hair, ear, eye and nail care?	Yes No
*Are you willing to provide these services?	Yes No
*Why do you want a rescued pet and how are you prepared to meet its special needs?
*Under what circumstances would you not keep the dog?
*I acknowledge and agree that Bichons and Buddiesis not responsible or liable for any injury, damage, or harm caused by this pet.	Yes No
*If I can no longer keep the animal, I will notify Bichons and Buddies IMMEDIATELY and work with them to place the animal in an approved home. However, I understand that the adoption fee is nonrefundable.	Yes No
*I agree that Bichons and Buddies may make a visit, at a mutually convenient time, to ascertain that all the above conditions have been satisfied.	Yes No
*I understand that to the best of B&B’s knowledge the animal is in general good health, with the sole exception(s) specifically set forth in exhibit “A”, attached hereto and incorporated herein. Notwithstanding the forgoing, B&B makes absolutely no representations and/or warranties as to the age, temperament, and/or health of the animal (except in exhibit “A”) and I have not relied on any representation and/or warranties in entering into this agreement.	Yes No
*This Agreement is intended to be a complete statement and contains all of the understandings between me and B&B and that this agreement may not be modified except in writing and signed by both parties.	Yes No
*I am at least twenty-one (21) years of age and wanting to adopt a dog. I understand, that this Bichon Frise or Bichon mix, MUST be a INDOORS pet. This dog will be an inside dog and will not be left unattended outside. I further understand, if for ANY reason, that this adoption does NOT work out, I will return it to Bichons and Buddies.	Yes No