Adoption Application
Please complete this form if you are interested in adopting a canine/feline from Macomb County Animal Control. All information collected is kept confidential and necessary for the approval process.
APPLICANT NAME
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First Name
Last Name
ADDRESS
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PHONE NUMBER
*
Please enter a valid phone number.
EMAIL ADDRESS
*
example@example.com
DRIVERS LICENSE NUMBER (confidential)
*
DATE OF BIRTH
*
-
Month
-
Day
Year
Date Picker Icon
I CURRENTLY LIVE IN A
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House
Condo/Townhouse
Mobile Home
Apartment
THE RESIDENCE IS:
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Owned by me.
Rent/Lease
Live with parents/someone else
HOW LONG HAVE YOU LIVED AT THIS ADDRESS?
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Landlord/Lessor Information
This section of the application helps us collect information about your current landlord/lessor.
LANDLORD/LESSOR NAME OR MOBILE COMMUNITY:
*
LANDLORD/LESSOR OR COMMUNITY CONTACT INFORMATION:
*
Home Environment
Please provide us with information on the individuals living in the home.
HOW MANY ADULTS LIVE IN THE HOME?
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AGES AND RELATIONSHIP OF ADULTS IN THE HOME:
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DO ANY CHILDREN LIVE IN THE HOME?
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Yes
No
Children
This section of the application helps us collect information on the current children residing in the home.
HOW MANY CHILDREN LIVE IN THE HOME?
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WHAT ARE THE AGES OF THE CHILDREN IN THE HOME?
*
Current Pets
This section of the application pertains to the current pets residing in your home.
DO YOU CURRENTLY HAVE PETS RESIDING AT HOME?
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Yes
No
HAVE YOU EVER HAD TO SURRENDER AN ANIMAL YOU OWNED TO AN ANIMAL SHELTER? IF SO PLEASE EXPLAIN:
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Current Pet Information
This section of the application allows us to collect information regarding current pets residing at the address.
ARE YOUR CURRENT PETS KEPT UP TO DATE ON VACCINATIONS?
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Yes
No
Not Applicable
NAME OF VETERINARY CLINIC YOU USE:
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Name and Phone Number of Vet Clinic
ARE THE DOGS YOU OWN/OWNED LICENSED?
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Yes
No
Not Applicable
HAVE YOU CURRENT AND PAST PETS BEEN SPAYED/NEUTERED?
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Yes
No
Not Applicable
PLEASE LIST THE PETS CURRENTLY RESIDING IN YOUR HOME:
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List all current pets including name, breed, age and sex.
Previous Pets
HAVE YOU OWNED ANY PETS IN THE LAST 5 YEARS?
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Yes
No
Past Pet Information
This section of the application allows us to collect information regarding the pets you have owned in the past 5 years.
WERE YOUR PREVIOUS PETS KEPT UP TO DATE ON VACCINES?
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Yes
No
Not Applicable
PREVIOUS VETERINARY CLINIC:
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Name and Phone Number of Vet Clinic
WERE THE DOGS YOU OWNED LICENSED?
*
Yes
No
Not Applicable
HAVE YOUR PETS BEEN SPAYED/NEUTERED?
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Yes
No
Not Applicable
PLEASE LIST THE PETS YOU HAVE OWNED IN THE PAST 5 YEARS:
*
List all current pets including name, breed, age and sex.
Adoption Consideration
Please indicate what type of pet you are interested in adopting.
WHAT TYPE OF ANIMAL ARE YOU INTERESTED IN ADOPTING?
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Dog
Puppy
Cat
Kitten
Other
NAME OF ANIMAL INTERESTED IN (If Applicable):
Canine Adoption
Please provide us with your plan for care of the dog/puppy.
IS YOUR YARD CURRENTLY FENCED?
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Yes
No
WHAT KIND OF FENCING DO YOU HAVE?
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4' Chain Link
6' Chain Link
4' Privacy
6' Privacy
Invisible Fence
Other
None
IF YOU DO NOT HAVE A FENCED YARD, WHAT ARE YOUR MEANS OF CONTAINMENT/EXERCISE?
*
Tether
Leash Walking
Other
Not Applicable
ESTIMATED ANNUAL COST (food, vaccines, supplies, vet care, etc) THAT YOU ARE PREPARED TO SPEND FOR THE CARE OF THE DOG YOU ARE CONSIDERING?
*
HOW MANY HOURS WILL THE DOG/PUPPY ROUTINELY BE LEFT ALONE DURING THE DAY?
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WHERE WILL THE DOG BE KEPT WHEN NO ONE IS HOME?
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WHERE WILL THE DOG SLEEP?
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HOW WOULD YOU HANDLE CANINE BEHAVIOR ISSUE(S)?
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WOULD YOU CONSIDER TAKING THE DOG TO TRAINING CLASSES IF NEEDED?
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Yes
No
Maybe
UNDER WHAT CIRCUMSTANCES WOULD YOU NOT KEEP THE DOG?
*
Feline Adoption
Please provide us with your plan for care of the cat/kitten.
ESTIMATED ANNUAL COST (food, vaccines, supplies, vet care, etc) THAT YOU ARE PREPARED TO SPEND FOR THE CARE OF THE CAT YOU ARE CONSIDERING?
*
HOW MANY HOURS WILL THE CAT/KITTEN ROUTINELY BE LEFT ALONE DURING THE DAY?
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WHERE WILL THE CAT SLEEP?
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WHERE WILL THIS CAT LIVE?
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Indoor Only
Outdoor Only
Indoor/Outdoor
HOW LONG WILL YOU ALLOW THE CAT TO ADJUST TO A NEW HOME AND OTHER CATS (if applicable)?
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WHAT CAT BEHAVIOR(S) CAN YOU NOT TOLERATE?
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HOW WOULD YOU HANDLE FELINE BEHAVIOR ISSUE(S)?
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WHAT ARE YOUR THOUGHTS ON DECLAWING?
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UNDER WHAT CIRCUMSTANCES WOULD YOU NOT KEEP THIS CAT?
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Other Adoption
Please provide us with your plan for care of the pet.
ESTIMATED ANNUAL COST (food, vaccines, supplies, vet care, etc) THAT YOU ARE PREPARED TO SPEND FOR THE CARE OF THE PET YOU ARE CONSIDERING?
*
WHERE WILL THE PET BE KEPT?
*
HOW WOULD YOU HANDLE THE BEHAVIOR(S)?
*
UNDER WHAT CIRCUMSTANCES WOULD YOU NOT KEEP THIS PET?
*
Adoption Agreement
Please note we reserve the right to refuse adoption to any applicant.I understand that many of the animals at the Macomb County Animal Control are strays, therefore their health and veterinary care history is unknown.I understand that all animals available for adoption have received age appropriate and species specific vaccinations, treated for intestinal parasites if observed and have been tested for canine heartworm or feline leukemia/FIV.I understand that the Macomb County Animal Control does not perform any diagnostic testing or extensive physical examinations and therefore cannot make any health guarantee for the animal you are adopting.I understand as the adopter, I am responsible for any future veterinary expenses. Adoption fees are not refundable.I understand that by completing this agreement that I may be subject to a background check (Logan’s Law) and information provided may be verified.I agree to treat the animal I am adopting in a kind and humane manner; to provide adequate food, water and shelter; to keep the animal current with vaccinations; to provide veterinary medical care when needed. If for some reason I am unable to keep the animal, I agree to return it first to the Macomb County Animal Control. If Macomb County Animal Control is not able to take the animal, I must provide housing for it until another suitable home is found.
By clicking SUBMIT it certifies that you are eighteen (18) years of age or older, that you have read this agreement in its entirety, that the information you have provided is accurate and true, that you will abide to the terms of this adoption agreement.
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I agree to Macomb County Animal Control terms and conditions.
Submit
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