Standard adoption form

Hallswood Animal Sanctuary

SUPPORTED Domestic animal adoption form
Adopter name*

First NameLast Name
Phone number*
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Animal name*
Please include the name of the pet as it was advertised and include the name you plan to change it to, if applicable.
Microchip number, if applicable
Animal age*
We often use vet given approximations if no formal date of birth is known.
MaleFemale
CatDogRabbitGuinea PigHamsterChickenOther
If Other, please state species
e.g fish, mouse, budgie
Animal breed
Animal colour
Last flea treatment date and product used
Next flea treatment is due 4 calendar weeks from last treatment date, unless otherwise stated.
Last worm treatment date and product used
Please refer to your vet or manufacturers packaging for recommended treatment intervals.
Current feeding information
Supported adoption specifics

PLEASE make sure you fully understand and agree with the terms laid out in this section.
EXISTING Vet recommend diet - wet, dry or bothEXISTING Short term vet prescribed medication*EXISTING Life/long term vet prescribed medication*Other - please detail below
If Other, please detail here -
Please provide information on the existing conditions or dietary requirements and any medications and/or special diets, and whether the sanctuary will cover the cost of these in full or make a partial payment towards.*
Supported adoptions are offered, where necessary, for animals that have EXISTING medical or dietary needs that would not be covered by the adopters own pet insurance.

Any conditions or requirements that arise post adoption, that are not covered in this supported adoption contract, are the sole responsibility of the adopter(s) and it is recommended that suitable pet insurance is arranged for the animal at the adopters earliest convienece and fully at their expense.

The animal MUST remain registered at the Hallswood Animal Sanctuary appointed vet.

The Sanctuary will cover the consultation costs at the registered vet to allow prescriptions to be issued.

IF the animal named in the Supported adoption contract needs to be seen by a vet because the covered condition has changed or worsened, the adopter MUST contact the Hallswood Animal Sanctuary owner, Lyz Hall - 07549991920, at the earliest possible time and PRIOR to booking a vet appointment for permission. Failure to do this could result in the adopter being liable for any costs resulting from the unauthorised vet treatment.
Adoption Decleration

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that animals adopted from Hallswood Animal Sanctuary remain the property of the sanctuary.

I understand that Hallswood Animal Sanctuary reserves the right to conduct follow up visits and to ask for updated information on the animal, including and not limited to - change of
address, contact numbers etc.

By signing this agreement you are undertaking a continuing pledge to maintain a well cared for and loved animal.

I understand that the named adopter(s) is/are responsible for all food and medical needs of the animal NOT SPECIFICALLY DEFINED AS COVERED BY THE SANCTUARY for the duration of the animals lifespan, once adopted.

If at any time you cannot continue to care for the animal, as per this agreement, this animal MUST BE RETURNED INTO THE CARE OF HALLSWOOD ANIMAL SANCTUARY.

We ask that this information is also known to family and friends so, if at anytime your adopted pet is unable to continue with you everyone knows who to return it to.
Date of adoption*

MonthDayYear
Date
Signed*

First NameLast Name
Should be Empty:

Hallswood Animal Sanctuary

Supported adoption specifics