Personal Contact Information               

Veterinary Reference NOTE: The new federal laws protecting privacy require you to contact your vet and give them permission to speak with MinPinHaven Rescue regarding the status of your pet's records.            

Personal Reference           

Previous and Current Pets Information Do you presently own any pets? YesNo If yes, list names and kind for each pet. (ex: Star - dog) Are your pets spayed/neutered? YesNo If not, why not? (please explain below) Under what name are your vet records kept? Have you previously owned pets? YesNo If yes, what kind and what happen to them? (please explain) Please provide name and phone for the vet used with the above pets.   

Home Environment Information Is your yard completely fenced? YesNo What type of fence? Block Wood Chain Link Other Height of fence? 3ft or less 4ft 5ft 6ft or more Do you live in: House Condo Apartment Manufactured Home Other Own your home? YesNo Do you have an HOA? YesNo If no, do you have permission from your landlord to have a dog? YesNo What is your dog/s per home limit? Deposit required YesNo Name of landlord. Phone: Do you have a kennel for the dog? YesNo How many hours each day will the dog(s) be alone? Do you have children? YesNo Number and age of children. Where will the dog be when you are away from home? Who will care for the dog while you are on vacation?

Dog Selection Information Have you previously had a miniature pinscher? YesNo If so, where is that dog today? Are you interested in a particular dog (explain)? Do you have a preference as to sex or color of dog (explain) Will you agree to a home visit by one of our volunteers? YesNo Are you willing to enroll in obedience classes? YesNo Do you understand that any miniature pinscher should never be allowed off leash other than in a completely fenced area? YesNo Additional comments: An incomplete application will delay the approval process. Please do not submit an application if you are under 21 years of age.