Your Name:

Phone (home):

Phone (cell):

Phone (work):

Physical address:

E-mail address:

Best time to reach to reach you:

Why do you want a rescue Vizsla?

Have you owned a Vizsla before? Yes No

Do you have a Vizsla now? Yes No

Sex of dog wanted: Female   Male  No preference

Age of dog wanted:

Other qualities you are looking for in a rescue Vizsla:

Would you be willing to take a Vizsla mix? (non-purebred Vizsla)
Yes   No

Will the dog live inside or outside? inside  outside

Do you have a fenced-in yard? Yes No

How high is the fence?

Do you have children in the home and what are their ages?

Do you have other adults in home? Yes  No

Are they in accord with owning a Vizsla?  Yes No

Do you or any family members have any pet allergies?Yes No

Other breeds of dogs in home (age, sex, altered)?

Do you have cats? Yes No

Other pets?

How many hours per day will the dog be alone?

The Vizsla is a high-energy dog. How will you provide exercise?

Do you own your home or rent?

If you rent:
    Do you have permission from your landlord to own a dog? Yes  No

    Landlord's name and contact information (phone number):
       

What is the name/phone# of your veterinarian?
 

Please list 2 personal references (name/phone#, no family members or relatives):
#1)

#2)

Sometimes Vizslas coming into rescue display behavior which is not considered acceptable such as fear, aggression, poor housebreaking, overly clingy or distant. This is usually due to a lack of proper socialization, training in the former household, or from commercial breeding facilities. Tell us what you know about Vizslas, or anything else you would like us to know and what knowledge or experience you can provide, such as training, understanding and love to promote a stable life for the rescued Vizsla?

What other information you would like us to know?