Roane County Paws Adoption Application

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Email (Initial contact will be made here)

example@example.com

Employer

Personal references: Name and phone number (please list 2)

Do you currently have pets?

YesNo

Please list all names and type of pets in home.

Are all pets up to date on vaccinations and spayed/neutered?

YesNo

Roane County Paws requires all current pets in the home to be up to date on vaccinations and spayed/neutered, unless advised against by veterinarian. If vaccination history can not be verified with the vet listed, the application will be denied. Please include the human name that the pet's records are listed under with the veterinarian. Whether pet's receive care/services from a private animal clinic or low cost clinic, ALL vetting information must be provided.

Veterinarian Name/Contact Information:

Additional veterinary information:

Please list where you buy your pet’s heartworm prevention and flea tick prevention. (Veterinarian’s office Chewy, 1-800-PetMeds, etc)

Do children live in the home?

Age 0-5Age 6-12Age 13+No children

Do you plan to keep this pet:

IndoorIndoor/OutdoorOutdoor

Do you have a securely fenced yard?

YesNo

Do you rent or own your home?

RentOwn

If renting, please provide landlord/property management name and contact info.

Have you ever surrendered a pet to the shelter?

YesNo

If yes, please explain:

Do you understand that the animal may take up to 3 months to fully transition into their new home.

YesNo

Are you prepared to work with behavioral challenges that may arise during the pet’s lifetime?

YesNo

Name of animal interested in:

Please add anything you would like for us to know!

Please allow 3-5 business days for application processing. If application is incomplete or any information can not be verified, the application will be denied. Please contact roanecountypawstn@gmail.com for questions.