Goldheart Golden Retriever Rescue

If you would like to adopt a Golden, please fill out and submit the application below. There is a $20 application fee that must be received before your approval process can be completed. After you submit your form you will be redirected to a page so you can pay this fee online. This small fee will help defer a portion of the costs of preparing our rescued Goldens for adoption. Thank you.

Application

Please Click to Select
Adoption Application Foster to Adopt Application Foster Care Provider Application
Name *
Age *
Occupation *
Co-Applicant
Co-Applicants Age
Co-Application Occupation
Service Area *Which Service Area are you in?
Address *
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone *
Work/Cell Phone
Email *
1. Type of Residence *
House Townhouse Apartment Condo Mobile Home Duplex With Parents
2. Do you own or rent? *
Own Rent
Attention Renters:A copy of your lease, or a notarized statement from landlord confirming a large dog is permitted must be attached or application can’t be processed until we receive it.
Upload a copy of your landlords permission here.
3. How did you hear about GHGRR?Please specify (i.e. persons name)
4. Have you applied to other rescues? *
Yes No
If so, how long ago?
Have you been approved?
Yes No
Have you applied to foster, adopt or both? *
Foster Adopt Both
A successful adoption depends on selecting the right Golden for your household and a good understanding of the dog’s needs and care requirements. Please help us with this process by answering the following questions fully and completely.
5. Why do you want to adopt a golden retriever? *
6. Will the dog be used for hunting, protection, companion, guard dog ?
7. Have you ever owned a dog? *
Yes No
Have you ever previously owned a golden? *
Yes No
8. Rescued Goldens vary in age. What age do you prefer? *
Under 1 yr. 1-3 yrs. 3-6 yrs. Over 6 yrs. No Preference
9. Do you prefer: *
Male Female No Preference
10. Would you consider a Special Needs Golden that requires medication for a permanent but controlled condition?
Yes No
What conditions?
11. On a scale of 1-5what activity level best fits your family situation? *(1 being a very quiet dog and 5 being a very energetic dog)
1 2 3 4 5
12. Good dog care in our area can easily cost $1000 or more annually. Are you willing and able to spend this amount to support a dog? *(This includes annual vet care, inoculations, parasite testing, monthly heartworm preventative, quality dog food, toys, miscellaneous equipment, boarding/kennel/pet sitting fees, grooming, supplies etc.)
Yes No
13. Do you have a completely fenced yard? *
Yes No
Type of fence?
Height of fence?
Approximately how large is the fenced area?
If no, would you consider installing a traditional fence?
Yes No
Would you consider installing an invisible fence?
Yes No
14. How will your dog be exercised? How Often? Will the dog be allowed off lead? Who will supervise these outdoor activities? *(This includes any time your dog is outdoors.)
15. Will the Golden ever be tied or left outside for exercise or potty breaks? *If YES, please explain.
16. Do you have any of the following? *
Dog Door Outside Kennel Dog Run Tieout Stake Overhead Cable Crate None of the above
17. Please list all adult residents of the home other than applicants.
18. How many children are in the home? *
How old are they? (list ages)
Do they have experience with large dogs?
Yes No
What will children’s involvement in the new Golden be?
19. Do you baby sit or provide in home child day care? *
Yes No
If so, how often & for how many?
20. Where will the Golden stay when no one is home? Be specific. *
How many hours alone? *
21. Where will the Golden sleep at night? Be specific. *
22. Is someone home during the day? If so, who in your household? *
23. Do you have other pets? Please list them and describe their temperament. *(breed/age/sex/altered/dominant/submissive/friendly/hyper/jealous/grumpy, pls also add special needs you’re accustomed to care for routinely i.e. clean/medicate ears, meds, orthopedic or surgical rehab, clipping nails, brushing teeth, etc)
Where are you other pets now?
24. Are your other pets up to date on vaccines and Heartworm preventative? *
Yes No
If not, why not?
25. Please describe a typical day in your household starting from the time you get up until you go to bed. *
26. Who will be primary care taker? *
Who will be the secondary care taker?
27. Who will care for your Golden while you vacation? *
28. If you move, what will happen to the Golden? *
29. Are you prepared and willing to be responsible for the care of the Golden for the next 10 or more years of his life? *
Yes No
30. Does anyone in the household have allergies? *
Yes No
Does anyone in the household have asthma? *
Yes No
If so, how is it controlled?
31. Have you participated in any of the following with a former or current dog?
Obedience Classes Agility Classes Canine Sports
If so, please explain where, when, which sport (if any), if you finished the course, and if not, why not?
32. Are you willing to attend obedience classes with your new dog? *
Yes No
If not, why not?
33. Have you ever crated a dog? *
Yes No
Are you willing to do so now?
Yes No
34. If you prefer not to crate why?
35. How many hours are your dog(s) to be alone at home each day? *
Where will they spend their time? *
Crate Free in home Confined to a specific area
If in a specific area, please explain.
36. Has a dog ever been stolen, lost or die prematurely? *
Yes No
If yes, please explain.
37. Has it ever been necessary to sell or give a pet away? *
Yes No
If yes, please explain.
38. Have you ever surrendered a dog to a shelter? *
Yes No
If yes, please explain.
39. Please provide the name and phone number for two non-family references:
Reference 1: Name *
Reference 1: Phone *
Reference 2: Name *
Reference 2: Phone *
Reference 3: Name *
Reference 3: Phone *
40. Who is your intended veterinarian?
Please contact your vet and let them know we will be calling. If not, there may be a delay in your application. Thank you.
Name *
Phone *
Address *
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
By clicking the Submit Button below:I acknowledge that all information provided on this form is true and correct. I/we also acknowledge that a home visit will be scheduled before the application process can be completed. I/we give GHGRR permission to check all my/our references. I/we understand that any misrepresentations of fact may result in the decline of my/our application and/or removal by GHGRR of the adopted dog from my/our possession.
Application Fee *

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Adoption Application Form

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