Small Animal Adoption Application

Small Animal Adoption Application

Baltimore Humane Society | 1601 Nicodemus Rd, Reisterstown, MD 21136
Our goal at The Baltimore Humane Society is to ensure the best possible match for the adopter and the animal. Each animal has unique characteristics and specific needs. We make every effort to ensure that animals are matched with suitable adopters so they can remain in their new homes for life.

Please complete the following application to begin the pre-approval process. This application is for our small animals in general, not for a specific small animal in our care. We are open for walk-in visitations on Mondays from 12:00pm to 3:30pm and Tuesday through Sunday 12:00pm to 4:30pm. NO APPOINTMENT NECESSARY. Please contact the adoption center via 410-833-8848 Ext 2 or animalcenter@bmorehumane.org if you have any questions.
What species of small animal are you interested in adopting?*

RabbitGuinea pigHamsterGerbilMouseRatFerret
Primary Caretaker's Legal Name:*

First NameMiddle NameLast Name
Date of Birth:*

MonthDayYear
Date
Government Issued ID Number (i.e. driver's license, military ID, etc.)*
Current Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*
Please enter a valid phone number.
Home Phone Number (if applicable)
Please enter a valid phone number.
Email Address*
example@example.com
Are you a college student?
Are you a first responder, active military or veteran?*
How many people currently live in your home with you?*

What type of household describes your current residence?:*
Do you rent or own your home?*

RentOwn
Are you aware of any restrictions your landlord may have regarding pets?*
How would you describe your household?*

Quiet/sedateAverageBusy/active/loud
Have you ever adopted/owned an animal before?*
If you've applied for or adopted an animal before, where is that animal now?

Lives in my homeRehomed to friend/family memberSurrendered to another shelterRan awayPassed awayOther
If you've had to rehome/surrender a pet before, please explain. *
Who are you adopting a small animal for?*

MyselfA family memberSomeone elseOther
Do you currently have any pets living in your home?*

YesNo

What is your pet's current veterinary hospital/clinic's name and number?*
Please give us the name and phone number of your previous primary veterinarian
We need to ensure that your current pets are up to date on their rabies vaccine, so if you could please upload the rabies certificate, that will expedite the processing stage of your application.

Upload a clear image or pdf file
Cancelof
Do you or any household members have pet allergies?*

Yes, they are mild and we do not need medicationYes, we take medication for themNo
Will your small animal be housed in a cage/exercise pen?*
Please describe the size and type of material of the cage/exercise pen:*
How much time per day will you be able to interact with your small animal?*

None1-2 hours2-3 hours4 or more hours
How do you feel about an energetic/active small animal that is always getting into everything?*

Do not want to live withDepends on the situationFineOther
Is it important that your small animal likes being held/picked up?*

YesNoI don't know
Does your small animal need to adjust to new situations quickly?*

YesSomewhatNo
Under what circumstancess would consider giving up/returning your small animal? (check all that apply)*

MovingDivorce/separationLitter box problemsAllergiesToo time consumingPet's medical problemsIncompatible with other petsNew babySheddingDestructive behaviorChildren lost interestBehavioral problemsPersonal medical problemsI would do everything I could to keep my new pet
How did you hear about The Baltimore Humane Society? (check all that apply)*

Friend/family/colleagueTVRadioPrint AdFacebookGoogleAnother shelter/rescueOther
I understand that completing this online application does not guarantee me a cat adoption from the Baltimore Humane Society and I acknowledge that its purpose is to ensure a strong match between each potential adopter and pet in their care. I further agree to respect the organization's adoption policies and have provided the information above truthfully and to the best of my knowledge.*

I understand
Should be Empty:

	First Name	Last Name	Full Date of Birth (00/00/00)
Household Member #1
Household Member #2
Household Member #3
Household Member #4
Household Member #5
Household Member #6
Household Member #7

	Species	Name	Age
Pet #1
Pet #2
Pet #3
Pet #4
Pet #5