Pet Adoption Application Form

Adoption Application, Contract and Waiver

Perspective Pet Parent*

First NameLast Name

Name of Pet You Wish to Adopt*

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?*

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other dogs?

OwnRent

What is your landlord's pet policy?*

Are there children in the home? (If yes, please list ages)*

If you answered "Yes" to the above question, please provide detail:

How many hours per day would the pet be alone?*

If you have to leave town, emergently or planned, where would your pet stay?*

How would you deal with behavioral issues such as inappropriate urination, destructive behavior, unruly behaviors in your pet?*

By clicking the submit button, I understand there is an adoption fee associated with adoption of a pet from James Street Veterinary Hospital.
By clicking the submit button, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify James street veterinary hospital.
By clicking the submit button, I agree that any medical expenses that arrise are my responsibility.
By clicking the submit button, I understand that James street veterinary hospital will disclose any of the pet's health or behavior issues known before adoption is completed.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent*