Today's Date
Today's Date
Name *
Home Phone *
Home Phone
Work Phone
Work Phone
Do you often have other people visiting your home?
Other children?
Is everyone in the residence and family agreeable to adopting a dachshund?
Have your children (if applicable) been exposed to dachshunds?
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?
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 Dena Delgado and Southern California 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?
Have you ever owned a dog?
Have you ever owned a DACHSHUND?
Do you currently own any other pets?
Have ALL of the animals listed above (if any) been spayed or neutered?
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 sometimes 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?:
Are you willing to adopt a dachshund that is:
Not reliable with children?
Physically handicapped?
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:
Own or Rent?
If renting, is landlord agreeable to you having a rescued dachshund?
Do you have a yard?
If not fenced, do you have an exercise program for the dog?
Do you have a swimming pool or spa?
If yes, is it safety fenced?
If not safety fenced, do you have a pool alarm system?
Are there stairs in your residence?
Would you be willing to take the dog for obedience training if needed?
Are you familiar with the necessary shots (annual) as well as heartworm testing and preventative?
Are you familiar with flea/tick treatment and prevention?
Please list preferences:
Name, address and telephone of:
Note: Failure to provide telephone numbers for for landlord (if applicable), veterinarian and references will result in your application being discarded without consideration.
Have you read and understand our adoption and rescue policies?
(enter your name to sign)

THANK YOU for your interest in adopting a dachshund from Southern California Dachshund Rescue (SCDR).
In order to determine which dachshund is most compatible for you and your family, we require all adopters to:

1.    COMPLETE this form. After we review your application, we’ll contact you within 2-3days.

2.     SCHEDULE a home check so that we can visit your home and meet you and your family.

3.     SIGN an adoption contract and pay an adoption donation, which helps us pay for rescue costs and medical expenses. 

*Applications that do not have three references and phone numbers will be automatically rejected.

If you are having trouble with the online application you can click here to download the adoption application below and email it back to us at

Thank you for choosing adoption!