Pet Adoption Application

Name*

First NameLast Name

Email*

example@example.com

Date of Birth*

Date

Primary Phone Number*

Please enter a valid phone number.

Alternate Phone Number

Please enter a valid phone number.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

The Address Above Is A:*

HouseApartment

READ AND INITIAL: My place of residence in a home, apartment, condominium, townhouse, public housing complex, or other housing complex allows for the ownership and occupancy of the pet I am applying to adopt. If the adopter is a tenant, the Adopter agrees to provide written permission from the landlord consenting to the animal adoption if requested by CARE Coalition.

Initials*

Which pet are you applying for?*

Name of Pet

This pet is a:*

CatDog

What is your occupation?

Who is your employer?

How many hours per day are you gone from home?

Drivers License Number

State

Social Media Usernames

(@TURTLECREEKVMC)

Number of Adults in Household*

Ages of Adults In Household

Relationship to You

Number of Children in Household*

Ages of Children In Household

Have the children had pets before?

YesNo

Is anyone in the house allergic to cats?*

How long have you lived at your current residence?

Do you expect your current family/housing situation to change?

If Yes, please explain.

Will others be handling or caring for this pet?*

YesNo

If something should happen to you, who would take responsibility for this pet?*

Have you ever moved from one residence to another without taking your pet? *

If Yes, please explain.

Have you ever adopted a pet from CARE Coalition or Turtle Creek Veterinary Medical Center before?*

YesNo

Are there other pets in your household? Please list below

Are your other pets spayed and neutered?*

YesNo

If No, please explain:

Are your other pets current on vaccinations?*

YesNo

If No, please explain:

Are your other pets current on heartworm prevention?*

YesNo

If No, please explain:

Are your other pets current on flea and tick prevention?*

YesNo

If No, please explain:

Who is your regular veterinarian?*

Phone Number*

Please enter a valid phone number.

Have you had any other pets in your adult life that are not listed on this application?

If Yes, how long did you have them and what happened to them?

How much do you expect to spend on maintenance for your pet in 1 year?*

Are you able to afford a bill of $200-$800 (or more) for emergency veterinary care?*

YesNo

If No, please explain:

If adopted, this pet will stay:*

Indoors OnlyIndoor and OutdoorOutdoors Only

Where will this pet stay while you are gone during the day?*

Where will this pet stay when you are traveling?*

List 3 behaviors that, in your household, would result in correction of the pet.*

How do you plan to correct the pet if it does something wrong?*

All potential new owners will be screened to ensure that our adoptable pets find the perfect match in their new home. This is an adoption application, not a contract, and is not a guarantee of adoption of the pet requested.

Signature

Printed Name

Date

PET ADOPTION APPLICATION