Adoption Application

Adoption Application

Incomplete applications can not be processed. Contact your Veterinarian to give permission to speak to us.
Applicant Information
Applicant Name

First NameLast Name
Applicant Age
Email
example@example.com
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Pet and Household Details
Type of pet you are looking to adopt or pet name used in advertisement:
Housing Situation:
If you rent, does your landlord permit pets?
Landlord name and phone number:
Type of Housing:
Are all members of your household in agreement about adopting a pet?
Number of people in household:
Household members age and relationship to you:
Household allergies to dogs or cats:
Why do you want to adopt a pet?
Preferred age of pet
Preferred energy level of pet
Is this pet going to be a gift for someone else?
If yes, who is the pet for?
On a regular day, how many hours will the pet be left alone?
Pet Care Preferences
What would you likely do if your new pet develops undesirable behavioral issues?
What is your plan if you become unable to care for your pet?
Are you planning on declawing your cat?
Do you plan on letting your cat outdoors?
Do you currently own any pets?
Current pets' names and ages (for dogs and cats)
If you currently have pets, are they spayed or neutered?
Do your pets go to the Veterinarian for routine exams and care?
Names and types of pets previously owned
Have you ever given away, rehomed, or surrendered a pet?
If so, why and where did the pet go?
Veterinary Information
Current or most recent Veterinarian - practice name, town, and phone number (provide name on account if different than applicant name)
Additional Veterinarians - practice name, town, and phone number (provide name on account if different than applicant name)
Personal Reference #1
Name

First NameLast Name
Relation to you:
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Personal Reference #2
Name

First NameLast Name
Relation to you:
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Agreements and Signature
Are you prepared to license your new dog or cat if your town requires it?
Do you agree to provide any necessary medical treatment at your own expense?
By entering your name below, you acknowledge and understand an application does not guarantee adoption. Staff reserves the right to refuse any adoption. Applications will be processed and suitable homes will be contacted in a timely manner to schedule a meet and greet.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Adoption Application

Applicant Information

Pet and Household Details

Pet Care Preferences

Veterinary Information

Personal Reference #1

Personal Reference #2

Agreements and Signature