Edit Form Title
Released Dog App
Thank you for your interest in one of our released dogs!
Please keep in mind that any other dogs in your home must be spayed/neutered and up to date on vaccines prior to adopting from us.
Preferred First Name
Last Name
Legal Name
Pronouns
Date of Birth
Street
City
State
Zip Code
Mobile Phone
Email
How did you hear about our program?
Please provide a name if you were referred by someone in our organization.
Have you adopted from us before?
Please select...
Yes
No
Home Environment
Does everyone in your household want a dog?
Please select...
Yes
No
Do you rent or own your home?
Please select...
Rent
Own
Do you have any restrictions on pet ownership? (breed, size, etc)
Please select...
Yes
No
Please provide additional information on any restrictions.
What best describes your home?
Please select...
Apartment
House
Townhouse
Other
What best describes your neighborhood?
Please select...
City
Suburban
Rural
Other
Do you have a securely fenced in yard?
Please select...
Yes
No
Please provide any additional details about your yard.
Are you able to travel to The Exceptional Sidekick in Newtown, CT to adopt a released dog in person?
Please select...
Yes
No
Please provide any additional details about your travel challenges.
Our expectation is that an adoptable dog will leave our care within a week of contacting you. Can you accommodate this timeline
?
Please select...
Yes
No
Do you have toddler age children living in your home who visiting frequently
?
Please select...
Yes
No
Is anyone in your home allergic to dogs
?
Please select...
Yes
No
Tell us about your experience with dogs
?
Do you have other dogs in your home?
Please select...
Yes
No
Tell us about your other dogs:
Will the adopted dog be living with a cat, chickens, or other small animals?
Please select...
Yes
No
Tell us about your cats, chickens or other small animals:
Preferences
Please select the preferred characteristics for the dog you wish to adopt. Our program dogs are all Labrador Retrievers.
Gender
Please select...
Male
Female
Either
Color
Please select...
Yellow
Black
Either
Age
Please select...
Puppy: 8+ Weeks Old (No Training)
Adolescent Puppy: 6-12 months
Young Adult: 1-3 years
Adult: 4-8 Years (Uncommon)
Retired Guide Dog: 9-12 Years
Are you willing to use a crate if one is recommended?
Please select...
Yes
No
Personality
Please share some information on the type of personality you are looking for in a dog.
What is your family's activity level that your dog would match with?
Please select...
Low
Average
High
Are there any special/unique considerations for temperament?
Who will be primarily responsible for caring for your dog?
Provide names and ages of all people living in your home
What is your dog's desired role in your family?
Please select...
House Companion
Children's Pet
Exercise/Running Companion
Emotional Support (provide comfort without trained tasks)
Therapy Dog (visit school, nursing home, etc, supporting others)
Competition Obedience/Agility
Facility Dog (dedicated to support a single location)
Provide support in public through specific trained tasks
Additional desired personality traits?
Have you owned pets in the past?
Please select...
Yes
No
On average, how many hours per day would your dog be home alone?
Please select...
0-1
1
2
3
4
5
6+
Where would your dog be when home alone?
Please select...
Crate
Kitchen
Mudroom
Other
Where will your dog sleep at night?
Please select...
Bedroom
Main Living Space
Mudroom
Other
If you are outside in an unfenced area, will your dog always be kept on a leash?
Please select...
Yes
No
If your dog would not be on a leash, please explain
Will your dog have access to a pool or water element for swimming?
Please select...
Yes
No
Will the pool/water element for swimming, be fenced and covered when not in use?
Please select...
Yes
No
Choice C
Are all other dogs in your home vaccinated and spayed/neutered?
Please select...
Yes
No
No other dogs in home
How will your dog get exercise (select all that apply)?
Please select...
Day Care
Dog Park
Hiking
Jogging
Daily Walks
Fetching
Run free in Backyard
Swimming
Other
What is your desired activity level for your dog?
Please select...
Low
Medium
High
There are many reasons why a dog would be released from service dog training. This list includes a wide variety of behavioral and medical reasons for release. Please select any conditions that would be acceptable to you in a dog. We would discuss any known conditions in more detail before determining if a specific dog would be the right fit.
Please select...
orthopedic issues
allergies
gastrointestinal issues
eye conditions
physical anomaly, which may or may not adversely affect the dog's health
cardiac issue
seizures/tremors
higher than average energy
separation anxiety, hyper-attachment
may bark frequently in certain situations
requires skilled handling and clear, consistent leadership from everyone in the household
distracted on leash, either by other animals or things in the environment
not compatible with other dogs
not compatible with cats or other small, uncaged animals
poor house manners, including but not limited to chewing inappropriate items, stealing food from counters, etc
Is there any additional information you'd like to share for your consideration of one of our released dogs?
Contact Information