Adoption Application

Please copy and paste the application below into an email or document, to complete and return to us.  We recommend you keep a copy, with your responses, for your records.  Once you have submitted your application, you will get an email confirming that it has been received. These emails are usually sent within 72 hours, but at times may be slower when application volumes are high, or during busier times in rescue.  Your patience is appreciated!.  If you have any questions about the application, or have not received a confirmation in a timely manner, please email the Adoption Director.

CSIR Hearder


If you have adopted from us, fostered for us, or submitted an application in the past, please contact us at  It may not be necessary for you to complete this application again.

General Information

Today’s Date:


Street Address:

City, State, Zip:

Cell Phone:

Alternate Phone:

Email address:

Are you 21 years of age or older?

Adoption Preferences

1. Which of our available dogs are you applying for?

2. What sparked your interest in adopting a Shiba Inu?

3. What are you looking for in a dog in terms of personality/temperament/energy level?

5. Do you have an age preference? (Mark all that apply)

  • Young Puppy—8 weeks to 6 months
  • Adolescent Puppy—7 months to 1 year
  • Young Adult—1 year to 3 years
  • Older Adult—4 years to 6 years
  • Senior-7 years or older
  • Whatever the rescue feels is the best fit for my situation

6. Do you have a preference between males or females? If so, please explain why.

7. Would you be open to adopting a Shiba Inu mix?

8. Would you be open to adopting a dog with special needs?

9. Do you have any planned life events/changes coming up that could impact your ability to provide a stable home for a newly adopted pup?  (i.e. moving, getting married/divorced, having a baby, starting new job, applying to grad school, etc.)

Family Information

1. Please list everyone that currently resides in your household, and their relationship to you.  For children, please indicate their age:

2. If you do not currently have children, do you plan on having children in the future?

3. Do you have children visiting the home regularly (i.e. grandchildren, nieces/nephews)? If so, what ages?

4. Are you, or your anyone living with you, allergic to dogs?

Animal Background

1. Please list any pets (dogs, cats, etc.) currently living with you.  Include their sex, age, and breed:

2. If you currently have dogs, are they spayed/neutered?

3. Describe the personalities of your current dogs/cats.

4. Have your current dogs/cats lived with dogs before?

5. If you do not presently have dogs, have you had dogs in the past? If so, what breeds?

6. Have you ever had to re-home,  or give up, of one of your animals? If so, why?

Your Environment/Lifestyle

1. Please indicate which type of home you currently live in. Please note: If you rent, we will need confirmation from your landlord that you are able to adopt a dog.

  • House
  • Apartment/Condo
  • Townhouse
  • Other (explain):

2. Do you have a fenced yard?

  • What type of Fencing?
  • What is the fence height?
  • Is the yard completely enclosed with fencing?
  • Is your yard attached to the house with an opening directly from the yard to the house?

3. Do you have a doggy door? Does it lock?

4. Does anyone, other than you, have free access to your yard (i.e. meter readers, landscapers, etc.)?

5. What is the longest your dog would be left home alone?

6. What is the average time your dog would be left home alone?

7. Where would your dog spend its time when left alone?

  • Crate (where would it be located?)
  • Confined to a room (which room?)
  • Loose in house
  • Backyard
  • Outdoor dog run
  • Garage

8. Where would your dog sleep at night?

  • Crate (where would it be located?)
  • Confined to a room (which room?)
  • Loose in house
  • Backyard
  • Outdoor dog run
  • Garage
  • In bed with owner
  • Dog bed on the floor

9. Do you travel regularly for work and/or pleasure?  How often?

10. Who would care for the dog when you travel?

11. How much exercise do you plan to give your Shiba Inu on a typical day? (Mark all that apply)

  • No additional exercise, they have a backyard
  • Tug, fetch, play with toys
  • Play at the dog park
  • Walks (How often? How long?)
  • Running (How often? How far?)
  • Hikes (How long?)

12. How social of a dog are you looking for?

  • My dog goes to work with me
  • I take my dog with me to run errands/socialize/etc
  • I take my dog on dog friendly adventures

Training background

1. Have you ever had to work with any of your dogs on difficult behavior issues? (Mark all that apply)

  • House Training
  • Crate Training
  • Leash Pulling
  • Jumping on people/furniture
  • Separation anxiety
  • Dog reactivity and/or aggression
  • People reactivity and/or aggression
  • Resource guarding (aka Food/toy possessiveness/aggression)
  • Excessive digging
  • Excessive barking
  • Excessive chewing
  • Fearfulness of strangers/environment
  • Other (explain):

2. What did you do to try and resolve these behavior problems?

3. What types of training methods do you currently use with your dogs, or would you use with a Shiba adopted from our rescue? (Mark all that apply)

  • Treats
  • Clicker Training
  • Choke Chains
  • Scruff Shaking
  • Praise
  • Crate Training
  • Pinch/Prong Collars
  • Muzzling
  • Play
  • Leash Corrections
  • Shock Collars
  • Alpha Rolling
  • Other (explain)

4. Have you ever used a crate before?

5. Are you open to crate training or do you prefer a dog that is already crate trained?

6. Describe the purpose of crate training and ways to make it successful:

7. Would you prefer a dog that can be left out loose in the house when you leave the house?

8. Would you prefer a dog that would be left outside all day or when you leave the house?

9. Have you ever used a harness before?

10. Are you open to using a harness while walking your dog?

11. Would you prefer a dog that can go out for walks/hikes/adventures off-leash?

12. Have you ever take any professional obedience courses with your current/previous dogs? If so, can you describe ?

13. If your dog has an accident or destroys something in your home and you were not around to catch your dog doing it…what do you do?

14. If your dog pulls on the walk how would you fix it?

15. If your Shiba runs away from you, how would you attempt to catch him/her and what do you do when you get your Shiba back?

16. What would you do if your Shiba struggled, mouthed or bit at you while attempting to handle or groom him/her?

17. Are you willing to follow the rescue’s suggestions when it comes to training your Shiba?

18. What amount of training are you planning to put in with your Shiba?

  • None, I’d prefer a dog that is already trained to do what I need
  • I will train the dog one-on-one in my home
  • I will participate in the group training class that is included in the adoption from Colorado Shiba Inu Rescue for all Shibas under the age of 7
  • I plan on continuing my dog’s education past its basic commands with additional professional training courses or private sessions, beyond the training that comes with the adoption

19. Which behavior issues are you uncomfortable or unwilling working with? (Mark all that apply)

  • Pottying in the house
  • Excessive barking/howling
  • Excessive chewing
  • Excessive digging
  • Fear of sounds
  • Fear of people
  • People reactivity/aggression
  • Dog reactivity/aggression
  • Resource guarding (Food/toy aggression)
  • Does not get along with other pets
  • Does not get along with children
  • Escaping/running away/bolting
  • None, I am willing to work with my dog on any issues that may arise

20. If your Shiba begins to exhibit any type of behavioral issues, what are you most likely to do?

21. Under which of the following circumstances might you consider returning or rehoming your dog. (Mark all that apply)

  • Moving to an apartment/condo
  • Moving out of state/out of country
  • Excessive barking/howling
  • Excessive digging
  • Excessive chewing
  • Escaping/running away/bolting
  • Marry someone with allergies
  • Dog bites children
  • Massive vet bills
  • Dog loses control of bladder
  • Dog is untrainable
  • Dog doesn’t get along with current pets
  • Dog is not the kind of dog I thought it would be
  • Dog develops a chronic illness
  • Having a baby
  • Dog nips at strangers
  • Divorce/Separation
  • Other (explain)


Colorado Shiba Inu Rescue recommends that all adopters feed an all natural, limited ingredient diet free of corn, wheat, by-products and unspecified animal fat.

1. What kind of food do you currently feed your dog(s), or have you fed your previous dog(s)?

2. Why do you choose to feed this food?

3. What do you expect to spend on food each month for your Shiba?

Shiba Inu Knowledge

1. Please confirm you have read the “Shiba 101” page under the “About Shiba Inus” tab on our website and list any questions or concerns you have after reading it.

2. Please list any additional sources of information you have used to research the Shiba Inu breed:

3. Are you aware of and prepared to deal with the common health problems that Shibas are subject to including, but not limited to: Patellar luxation, environmental & food allergies, glaucoma, Peripheral Vestibular Syndrome?

4. Are you aware of and prepared to deal with the issues that typically affect dogs as they age including, but not limited to: cataracts, arthritis, dementia, and incontinence (inability to control their bladder)?


Please provide any pet related references that are applicable to you.  If you have never had a pet before, please provide a personal reference:

1. I have adopted from or fostered for the following rescue/shelter:

Rescue/shelter name:

Rescue/shelter phone:

2. I currently use, or in the past have used the following vet clinic:

Vet name:

Vet phone:

3. I currently use, or have in the past used the following groomer:

Groomer name:

Groomer phone:

4. I have never had a pet before, but want to provide a personal reference:



Relationship to you:

Additional Information and/or Questions

Please use this space to provide us with any additional information you want us to know when considering your application. You can also use it to ask any questions you might have about Shiba Inus, a specific dog, the adoption process, or our rescue.


Submitting Your Application

Please send a completed copy of this application to:

Thank you for choosing adoption!