Pet Adoption Application

Pet Adoption Application
Date:

MonthDayYear
Date
In order to be considered as an adopter you must:
- Be 18 years of age or older
- Have identification showing your present address
- Have the knowledge and consent of your landlord
- Be able and willing to provide a loving, safe and peaceful environment for this pet
- Be financially stable and willing to provide any necessary veterinary care
Pet ownership is a serious responsibility.
This application is to ensure that each person who adopts a pet is aware
of the responsibility, and is capable and willing to accept the responsibility
morally, physically and financially.
The following questionnaire has been designed to aid both you
and your family to adequately prepared to assume the responsibility
of pet ownership. Please be sure to ANSWER ALL QUESTIONS and feel free to add your own comments. If a question does not apply write N/A.
Name:
Age:
Phone Number

Area CodePhone Number
Email:
example@example.com
What is the best way to contact you?
Address

Address

Street Address Line 2

CityState / Province

Zip
Occupation:
Spouse's Occupation:
Please list the name, age and relationship to yourself of each person currently living in your house (ex Mary, spouse, 35)
Yes No
House in the cityHouse in the countryCondo / TownhouseApartmentTownhouseManufactured Home
What size is your property?
RentOwnLive with someone else
Length of time at current residence?
NoYes
YesNo
Is there a pet deposit? How much?
What is the name of the property owner/ agent?
Contact name and phone number:
Companion for you / family / another petGuard Dog
Gift (for whom)Add a new family member to the familyOther
Not ApplicableYesNo
YesNoOther
Indoor onlyMostly IndoorMostly OutdoorOutdoor only
Where will your new pet sleep at night?
In what areas of the house will the dog/cat be allowed?
0‐22‐44‐66‐88‐1010‐12over 12
Yes, woodYes, chain LinkYes, vinylYes, block wallNoOther
Height of fence
BalconyPoolPet DoorUnscreened Windows
YesNoOther
Yes No
Where do your pets stay if and when you travel?
PAST/PRESENT PET HISTORY
Please list the name, type, age, gender, and if pet is spayed or neutered of ALL current animals. (example: Duke, Yellow lab, 1 year old, male, neutered)
Please list age, type, gender and if the pet was spayed or neutered for all animals you no longer have and what happened to that animal. (Ex Rosie, German Shepard, spayed female, passed away due to old age)
NoYesOther
Date of last vaccinations:

MonthDayYear
Date
If adopting a CAT, do you plan to declaw?
How often do you think a dog/cat should go to the vet for routine care?
Name of current or last veterinarian? Name/phone number?
YesNoOther
Moving to another stateFleas or sheds too muchHaving a babyFinished school/ moving back homeRuins the furnitureChildren will no longer care for dogToo expensiveAllergiesGetting a divorce or marriedFound a new “no pet” rentalGrew too bigDigging/ ChewingWould not give up for any reasonOther
What would you do with your pet if you could not keep it for any of the reasons stated above?
YesNo
If yes, why?
Would you allow an inspection of your home and/or yard?
PLEASE PROVIDE TWO PERSONAL REFERENCES:
Name

First NameLast Name
EMAIL:
example@example.com
Phone Number

Area CodePhone Number
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
How did you hear about Nuevo Road Animal Hospital adoptions?
Is there anything else you would like to tell us that you think would be important when considering your application?
Please read and sign below: Many factors determine which applicant will be matched with a particular pet. If you are not able to adopt a pet today, it does not mean that you are not considered a good pet owner or that your home is not acceptable. Our goal is to place all animals into homes that will best suit their individual needs. Please ask for clarification if you have any questions.
I have completed this application truthfully and fully understand the adoption process.
Signature:

Clear
Date:

MonthDayYear
Date
If we do not call or email you within 7 days of receiving your application it means that either:

1. The pet was adopted by a previous applicant.

2. We felt the situation presented on the application was not the right situation for that particular pet.
THANK YOU FOR TAKING THE TIME TO COMPLETE THIS APPLICATION!
Should be Empty:

Pet Adoption Application

In order to be considered as an adopter you must:

PAST/PRESENT PET HISTORY

PLEASE PROVIDE TWO PERSONAL REFERENCES:

THANK YOU FOR TAKING THE TIME TO COMPLETE THIS APPLICATION!