Adoption Form

Adoption Form

Email: LCACC@logancountyky.gov
Name*
Full Address*
Phone #*
Email Address:
example@example.com
Own or Lease:*
Residence Type:*

HouseApartmentCondo/DuplexTrailerOther
If you rent/lease, have you obtained permission or read completely the guidelines to house the animal?

YesNo
When did you move into your current house*

MonthDayYear
Date
Landlord Name: (if leasing)
Occupation:*
Company:*
Name of Animal you want to adopt:*
Current or Veterinary you plan on using:*
I give my veterinarian permission to release any and all medical information about my animals to Logan County Animal Shelter:*

YesNoOther
My Reason for adopting this animal: (check all that apply)*

CompanionFor ChildrenHuntingOther
How many adults live in the house*
How many Children live in the house*
Ages of Children
Who will be responsible for this animal: (check all that apply)*

MyselfMy PartnerChildrenOther
How many hours per day will the dog be left at home alone?*
Are you a Frequent Traveler?*

YesNo
If YES, where will the animal stay while you are away?
Where will the animal live most of the time?*

InsideOutside
When the animal is outside, they will be:*

In Fenced YardInvisible FenceTiedOn a Run LineWalked on a leashLoose in the YardSupervised Loose in the Yard
In the event you need to move/relocate, are you willing to find a place that will allow you to bring the animal with you?*

YesNo
If you cannot, are you willing to return your pet to LCACC or re-home them?*

YesNo
How many other pets do you currently have?*
If you do have other pets, what types are they?

DogsCatsOther
Have you ever had to return an animal for ANY reason?*

YesNo
If YES, why?
If needed, would you be willing to enroll this dog in obedience training?*

YesNo
Are you willing to housebreak this dog? (typical amount of time is 4-6 months)*

YesNo
Are you willing to give this dog 1-2 months to adjust to a new home and routine?*

YesNo
For the purpose of adopting, the undersigned certifies that the above statements are true and complete. Logan County Animal Care and Control retains the right to deny an adoption due to false information, or if the Logan County Animal Shelter Director believes it to be in the best interest of the animal. All adoptions are NON- REFUNDABLE. If you do return your pet and it's past 7 days, you are responsible for owner surrender fees.
Adopters Signature*

Clear
Print Name*
Date*

MonthDayYear
Date
Should be Empty: