Pet Adoption Application Form

Perspective Pet Parent*

First NameLast Name

Email Address*

example@example.com

Phone Number*

Name of Pet You Wish to Adopt*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?

YesNo

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other animals?

Veterinarian Name

First NameLast Name

Veterinarian Phone Number

Please enter a valid phone number.

Do you own or rent your home?*

OwnRent

Please provide your landlord's information here:*

If this application is for a cat, do you agree to keep this cat indoors and not allow unrestricted outdoor access?

YesNoNot applicable, I'm applying for a dog

If this application is for a cat, there may be a stipulation that forbids declawing. If that is the case, would you still be interested in adopting this or another cat?

YesNoNot applicable, I'm applying for a dog

Do you have a yard?*

YesNo

Is it fenced? please describe

What is your landlord's pet policy?*

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?*

YesNo

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

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

Will you crate your pet?*

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

How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*

Personal References (MINIMUM OF ONE)

Attached photos of where the pet will primarily be kept (not required, but appreciated):

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo

Please provide a detailed description:

By clicking the submit button, I agree to go through the adoption process and an interview.
By clicking the submit button, I understand my references will be contacted.
By clicking the submit button, I understand there may be an adoption donation associated with adoption of a pet, but that it will not exceed $80 (if applicable at all).
By clicking the submit button, I understand that if I no longer want or can no longer care for my adopted pet, I agree to notify Rescue Center. BY EMAIL and provide a 7 day period to allow hospital staff to make arrangents for my pet to be taken back into foster.
By clicking the submit button, I agree to indemnify and hold harmless Windsor Animal Hospital or associates against any losses, lawsuits, claims, injury, and/or damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
By clicking the submit button, I verify all of the above information is true and accurate.
APPLICATIONS ARE REVIEWED AS WE RECEIVE THEM. We will review your application and contact you if you are approved to meet the pet which you are applying to adopt. Please do not contact us without first filling out the application.

Date

Signature of Potential Pet Parent