Cat Adoption Application

Serenity Animal Hospital Cat Adoption Application
Date*

MonthDayYear
Date
Name of cat(s) that you're interested in meeting
Name*

First NameLast Name
Date of Birth- for person who is filling out adoption application*

MonthDayYear
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Best time to call*
I am interested in a:*

KittenCat
What type of home do you live in? (house, apartment, condo, townhome, etc.)*
Landlords Name and number - if applicable, please let them know we may be calling.
Do you*

rentownlive with parentsOther
Current Employment Information*

Employed Full timeEmployed Part timeUnemployedRetiredStudentOther
If employed, please list your employer, job title/line of work and length of time employed there
How many adults live in your home?*
How many children live in your home?*
Age of children in the home*
Does anyone in the home have a known allergy to dogs or cats?*

yesno
Please describe your household*

ActiveNoisyQuietAverage
Current Veterinary Hospital Name & Number. Please call the ahead of time to let them know that it's ok to release information to Serenity Animal Hospital. Calling ahead speeds up the application approval process. *
If you have your current pet(s) medical history, please upload it here. This will also speed up the application approval process.

Browse Files

Cancelof
Please list your current & past pets: name, breed, age, *
Are your pet(s) current on ALL vaccinations? (including DHLPCA, Rabies, Bordetella, Fecal Testing, Heartworm Test, and Canine Influenza OR Feline Distemper & Feline Rabies)

yesno
Are your pet(s) spayed or neutered?

yesno
Are your pets given heartworm preventative year round?*

yesno
Are your pets given flea preventative year round?*

yesno
If you answered no to either of the last FOUR questions, please explain why
If you have every relinquished custody of a pet before, please explain why:*
I would be willing to adopt a: (select all that apply)*

Very high energy,active petcat that needs medicationcat that needs groomingMellow/easy going petshy catvery affectionate/attention seeking petpet that needs little to no grooming
Where will your cat spend most of the day?*
Number of hours (average) that the cat will be home alone?*
Who will have primary responsibility for this pet's daily care?*
Who will have financial responsibility for this pet?*
What will happen to the pet if you go on vacation?*
If you move in the future, what will you do with the pet you are planning to adopt?*
Will you allow the cat on furniture/beds?*
Will the cat have run of the house?*
Are you aware that veterinary care could cost up to $600 per year, without any serious illness?*
Do you agree to provide regular, yearly health care by a licensed Veterinarian?*
Do you agree to keep this pet as an indoor cat?*
Do you agree to contact Serenity if you can no longer keep this pet?*
What will you do if the pet is destructive while left alone?*
What would cause you to return your potential cat to us in the future? check all that apply*

biting/nippingmedical needsmarking/can't be house brokenfighting with current petscounter surfing/beggingchewing/destroying possessionsseparation anxietydivorce or death of spouse/partnerchanged my mind about having a petkids leave home/won't be caring for petchange in healthnew babynew partner doesn't like the petnew job/movingloss of incomeNONE OF THE ABOVE
Personal References- please list the Name, Number & Relationship for 2 references*
Have you ever owned a cat before?*
What is your opinion on declawing cats?*
Do you plan on declawing this cat?*
Where will you keep the litter box? How many will you have?*
What would you do if your cat didn't use the litter box?*
All of the information I have given is true and complete. This pet will reside in my home as a pet. I will provide it with quality cat food, plenty of fresh water, indoor shelter, affection, annual physical examinations, vaccinations, heartworm and flea preventative from a licensed Veterinarian. *
Should be Empty:

Serenity Animal Hospital Cat Adoption Application