Posting a purebred Basenji here implies that you are asking Basenji Rescue and Transport Inc. (BRAT) to help you place your dog(s) with a new family or individual.

Please note that neither BRAT nor the family or individual adopting your purebred Basenji is expected to compensate you any amount for the dog.

Our BRAT volunteers will evaluate your application and may be in contact with you before we determine whether we can assist you. BRAT does not guarantee that we will be able to help find your dog a new home.

Ideally, the Basenji should come with a crate (one in good condition), be current on all shots and heartworm medication, have been spayed/neutered, and have recent results from a fecal test. If your Basenji is not up-to-date on vetting—or if you're in a position to help—it would be greatly appreciated if you would make a donation to us to help off-set our costs while the dog is in our care, waiting for its forever home. The BRAT representative that contacts you may discuss this with you and explain how your money will be used.

Answer as completely as you can. Any information you can not supply, leave blank. PLEASE NOTE: The information you leave may be posted either on this Web site and/or on BRAT-owned mailing lists of volunteers and applicants. In other words, it will become public information. You may want to review our Privacy Policy. Click the link to read.

Please do not be intimidated by the length of this form. The more information supplied about the dog, the better a match can be made with a new owner.

Please note: Neither Basenji Rescue & Transport Inc. (BRAT), nor its volunteers, coordinators, representatives, Internet service provider and its officers, employees, contractors and representatives; and any other person, firm or corporation involved with the efforts or business of this corporation, shall be held liable or responsible for any claims or causes of action incurred as a result of the provision or restriction of information, services, contacts, adoptions, fostering, veterinary care or by the actions of any and all dogs transferred or referenced herein.

By completing and submitting this form, you attest that you have read the above disclaimer and agree to the terms therein.

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About Your Basenji

  
* Dog's name:
* What state is the dog in:
* Date of birth (approximate, if unknown):
Gender: Male  Female
Color: Red  Black  Tri  Brindle  Other 
Weight: (pounds)
Neutered/Spayed: Yes  No  Unknown 
Is the dog tattooed? Yes  No  Unknown 
Is the dog microchipped? Yes  No  Unknown 
Please note any identification information if tattooed or if microchipped include the chip number and name of registry service.

It is BRAT's policy to contact the breeder when asked to rehome a purebred Basenji. By providing the pedigree/breeder information to BRAT, you are authorizing us to contact the breeder. Responsible breeders welcome the opportunity to help rehome dogs of their breeding. In fact, responsible breeders often place Basenjis on contracts that require that the dog be returned to them. We appreciate your effort to provide any information regarding the dog’s breeder.
If you do not have the information, leave the field(s) blank.
 
AKC number:
Dog's registered name:
Sire's name:
Dam's name:
Breeder:
Breeder's address:
City, State, Zip, Country:    
Breeder's phone:
Breeder's Email address:
Have you contacted the breeder about returning your Basenji? Yes  No 
Did you purchase your Basenji from a pet shop? Yes  No  Unknown 
Please use this box to include any comments you may have about your Basenji's pedigree, the breeder of your Basenji and/or where you purchased the Basenji:

Health Information

  
Veterinarian:
Address:
City, State, Zip, Country:    
Phone:
Email address:
Is the dog healthy? If No, please explain any
health problems, conditions, allergies, etc. the dog has:
Vaccinations  
DHLP: Yes  No 
Parvovirus: Yes  No 
Rabies: Yes  No 
Do you have a rabies certificate? Yes  No 
Coronavirus: Yes  No 
Bordetella: Yes  No 
Lyme Disease: Yes  No 
Medical Tests  
Fecal: Yes  No   
If the fecal test found intestinal parasites,
check those found and use the space below to comment:		 Giardia  Coccidia  Roundworms  Whipworms  Hookworms
Tapeworms  Spirochetes  Flagellates 
Fecal Test Comments:
Heartworm: Yes  No      Negative  Positive 
Is the dog on monthly heartworm prevention meds?
If yes, list the last date given:		 Yes  No 
Urine tested for Fanconi: Yes  No      Negative  Positive 
DNA tested for Fanconi: Yes  No      Clear/Normal  Carrier  Affected  Pending 
Other tests: Yes  No 
Please use this box to briefly explain or give us more information about any of the above tests:
Is the dog on any other regular medication? Yes  No 
If the dog is on any other regular medication,
list type, reason, how administered, how often, etc:
If there is any other medical infomation you
would like to share, please do so:

Eating Habits

  
Eating schedule: Once a day  Twice a day  Unknown 
Type of food: Dry food  Wet food  Both  Unknown 
Brand(s) of food:
Begs for food? Yes  No  Unknown 
Food dislikes:
Favorite foods:
Additional feeding instructions:

Temperament
Briefly describe your dog's personality. Is s/he shy,aggressive, timid, confident, tolerant, snarky, well socialized, etc?
Lived with children? Yes  No  Unknown 
Likes children? Yes  No  Older kids only  Unknown 
Lived with cats? Yes  No  Unknown 
Likes cats? Yes  No  Unknown 
Lived with dogs? Yes  No  Unknown 
Likes dogs? Yes  No  Unknown 
Prefers men or women? Men  Women  Either  Unknown 
Likes strangers? Yes  No  Unknown 
Nips (playfully)? Yes  No  Unknown 
Bites (in anger)? Yes  No  Unknown 
Crate trained? Yes  No  Unknown 
House broken? Yes  No  Unknown 
Destructive inside house? Yes  No  Unknown 
Destructive outdoors? Yes  No  Unknown 
Dog is a climber? Yes  No  Unknown 
Dog is an escape artist? Yes  No  Unknown 
Easily startled? Yes  No  Unknown 
Wakes up grouchy? Yes  No  Unknown 
Rides well in car? Yes  No  Unknown 
Gets carsick? Yes  No  Unknown 
Rides in crate? Yes  No  Unknown 
Yodels? Yes  No  Unknown 
Screams? Yes  No  Unknown 
Where does the dog sleep?
(outside, in bed, in another room, etc)
List any other significant thing that a new owner
would want to know (recall word, bolting, etc.):

Your Information

  
* Your name:
* Address:
* City, State, Zip, Country:    
* Day/Cell phone:
Evening phone:
* Email address:
Time owned dog: (years, months)
Previous owner:
Reason for placement:
Placement deadline:
  (Please note: The placement deadline is solely for informational purposes. BRAT cannot guarantee that it will be able to rehome your Basenji by your stated placement deadline.)
Does dog have a crate? If so, please list the size, etc:
Have you advertised this dog for adoption elsewhere?
If so, please list all places where you have previously
posted the dog: