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Adoption Application

We use email almost exclusively to contact applicants. Please make sure we have good contact information.

Contact Information

Name *

First

Last

Email *

Cell Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

House Information

Do you own or rent your home? *

own
rent

If you rent, please provide your landlord's contact information

Do you have a doggy door? *

No
Yes, does not lock
Yes, lockable

Do you have a fenced in yard? *

No fence
No fence, dog park on or near property (for renters/condo)
Fence, wood/metal less than 4 foot
Fence, wood/metal 4 foot or higher
Fence, electric

Any comment about the fence?

Do you have a pool or hot tub? *

No pool or hot tub
Pool or hot tub with no fence
Pool or hot tub with fence that dog would not be able to enter pool area

Any comment about the pool or hot tub?

Co-applicant Information

Co-applicant Name

First

Last

Co-applicant Cell Phone

Household Information

Please list everyone in your household and their ages (include yourself). *

If you have children in the home, or who visit regularly, please tell us about their experiences with dogs. *

Do you work outside the home? How long are you gone during the day? How many days a week? *

Animal Care Information

Please list your animals, breeds, size, and ages *

Please list any previous animals, breeds, age and date of passing *

Have you ever returned a dog before? If yes, please explain. *

Have you ever bred a dog before? *

Yes
No

Do you use heartworm preventative and flea/tick for all your pets? *

Yes
No
N/A

Please provide name of heartworm preventative and flea/tick control you currently use.

Are all your pets spayed/neutered? *

Yes
No
N/A

Please provide current veterinarian address and phone number. *

Please provide previous veterinarian address and phone number if less than 3 years with current veterinarian. *

By submitting this application, you give permission to retrieve information from your veterinarian. I understand that my vet will be contacted to provide information about my current and/or previous pets. *

I understand and agree.

Dog Information

Which dog(s) are you interested in? *

What dog food do you currently feed? *

How will your new dog fit into your lifestyle? *

Are you looking for a low, medium or high energy dog? *

Low Energy - only serious couch or lap potatoes please!
Medium Energy - Walkies, playful, but cuddly too!
High Energy - Loves to run, play, fetch, goes full on til its time to sleep!
I'm open to anything!

Will you leash walk you dog? *

Yes
No
Other

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Will you allow your dog off leash outside of your fenced yard? *

Yes
No
Other:

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How will you introduce your dog to your family, friends, and pets? *

What do you consider to be unacceptable behaviors in dogs? *

How would you deal with these behaviors in your new dog? *

Does your home have steps? Please tell us how many and where (inside, etc.). *

Do you allow your current/previous dogs to go up/down your steps? *

Yes
No
N/A

Where will your new dog sleep? *

How long will your dog be left alone during the day? *

Never
1-2 hours
2-4 hours
4-6 hours
6-8 hours
Longer than 8 hours

Where will your dog stay while you are gone?

Free run of the house
Crate
Gated in a room
Other:

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Where will your dog stay when you go on vacation? *

Do you have experience with Dachshunds? *

Are you familiar with IVDD in dogs? *

Yes
No
Other:

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If you have had a dog with IVDD, please tell us what treatment options you pursued.

Personal References

Please provide contact information for two references not related to you.

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Reference #1 Name *

First

Last

Reference #1 Email *

Reference #1 Phone *

Reference #2 Name *

First

Last

Reference #2 Email *

Reference #2 Phone *

Anything else we should know? *

By submitting this form you give permission to retrieve information from personal references, and also acknowledge that as part of our process a home visit (either in person or virtual) will be made. *

I understand and agree

Cindy Lou's Sanctuary

354 Old Grade Rd.
Moncks Corner, SC 29461
843-809-2991

Adoption Application