Released Dog Application

We appreciate your interest in Service Dogs of Virginia’s (SDV) Released Dog program. The following application will allow us to better understand your home situation. Please answer all questions thoroughly, and contact us with any questions.

About You

Name

Address - City/State/Zip

Home Phone: *

Cell Phone:

Work Phone:

Household

A physical fence is required for all dogs released by SDV. Do you have a physical fence (NO electric fences) or an enclosure for the dog? * YesNo

Please describe the type and size of fencing. *

Please list the name, relation, and age of members of your household (include spouse/partner):

List below all animals that are part of your household (living indoors or out) and describe the temperament of each:

Do all members of your household want to adopt a dog? YesNo

How many hours a day, on average, will the pup be left alone? 0-23-56-89+

Where will he be left during that time?

If you work outside the home and the dog will be left alone for an extended period of time (six or more hours per day), are you wiling and able to engage the services of a neighbor or dog sitter to take your dog out for a mid-day break? YesNo

Describe your daily schedule (i.e., time you get up, go to work/school, other activities, bedtime, etc.):

How much exercise can you give the dog each day?

How will you exercise the dog?

Have you ever had a dog before? * YesNo

Are you willing to provide the dog with regular vet care (yearly exams, heartworm and flea and tick preventative, etc)? * YesNo

Are you aware that the average cost of caring for, feeding, and grooming a dog is about $700 a year. * Dog food: approximately $25/month or about $300 a year; we recommend suitable, premium dog food using human grade ingredients that provide optimal nutrition for a dog. * Regular vet care: monthly heartworm, tick and flea preventatives and yearly immunizations. We estimate the cost of vet care to be approximately $300/year for well dog maintenance. This does not include an emergency procedures or unexpected illnesses. * Replacement equipment: including, but not limited to, leashes, collars, and bowls, toys and treats: approximately $150/year. YesNo

Training

Have you ever trained a dog before? If yes, what style of training did you use?

If yes, describe the style of training that you used.

Are you willing to make a crate available for the dog? * YesNo

Do you agree to pick up, clean up, and dispose of the dog¹s waste if he eliminates in public? * YesNo

Are you willing to attend training classes with the dog? * YesNo

Do you agree to pick up, clean up, and dispose of the dog’s waste if he eliminates in public? YesNo

Are you willing to purchase toys, treats, and simple equipment for the dog? YesNo

Please provide a the NAME, ADDRESS and PHONE number of a personal reference. This must be someone who does not live with you: *

SDV DOES NOT OFTEN RELEASE DOGS AND PLACES DOGS IN ONLY THE MOST SUITABLE HOMES. SDV REQUESTS A $1000 PLACEMENT FEE FOR OUR RELEASED DOGS.

Questions? Call (434) 295-9503 or e-mail: peggylaw@servicedogsva.org