Adoption Application

Please review the application and ENSURE ALL INFORMATION IS COMPLETED AND LEDGIBLE without phone numbers, email, and vital information missing.
PLEASE COMPLETE ENTIRE FORM
Animal Name
Animal Choice
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email
example@example.com
Governement Issued ID#/Drivers License
ID State
Current & Previous Pet History
Do you currently own any pets?
List Pets Currently Owned Below: (Name, Age, Breed, Species)
Spay or Neutered?
What happened to your last pet?
If your pet died or you gave it to an Animal Shelter/Rescue Group, please provide a reason
Veterinarian you currently or intend to use:
Where will this animal be kept?
If in a crate, approximately how many hours per day?
Is your yard fenced?
Residence Information
Do you own or rent your home?
Length of time at current residence
If your landlord requires you to pay a required pet deposit or increased rental fee, are you willing to do this?
Do you intend to move or relocate in the foreseeable future?
If yes, are you willing to ensure the animal will be allowed at your new home?
You must have landlord permission to own a pet. We will call to verify. You may not adopt a pet from HSHC if your landlord does not allow pets. NO EXCEPTIONS
Landlord Name
Landlord Phone Number

Area Code Phone Number
Falsifying landlord information will result in appropriate legal action, including, but not limited to, impound or animal, revocation of the adoption and associated legal fines and fees.

90% of all animals surrendered to animal shelters are because the owner is moving or has moved and their pets are not allowed. There are numerous places that allow pets; some require pet deposits and additional monthly fees. Pets are a forever commitment. If you cannot afford to pay additional monthly fees for them, please do not adopt. It is the owners responsibility to verify with their potential landlord, before committing to the lease, whether pets are allowed.

PLEASE READ, INITIAL, SIGN & DATE THE ADOPTION CONTRACT

Please read carefully and initial each item stating that you agree and understand the terms of this LEGALLY BINDING Adoption Contract.
1. ALL animals must be spayed or neutered. NO EXCEPTIONS. If you are adopting a puppy or a kitten, this adoption is NOT final until the surgery has been performed & is considered a “Foster to Adopt”. Failure to keep your spay/neuter appointment will result in the impound of the animal.
Initial to agree.
2. The Humane Society of Henderson County (HSHC) has the right to refuse to adopt any animal or to deny any person for adoption. Previous owner surrenders will not be allowed to adopt an animal from HSHC for a minimum of (1) one year from surrender date.
Initial to agree.
3. All animals adopted from HSHC must be spayed / neutered prior to adoption being finalized. Failure to keep your spay/neutering appointment will result in the adoption form being revoked and impoundment of the animal. No-show fee, court fines and other fees may be associated with this action.
Initial to agree.
4. HSHC DOES NOT GIVE REFUNDS OR EXCHANGES ON ANIMAL ADOPTIONS. ALL ADOPTIONS ARE FINAL.
Initial to agree.
5. It is imperative to have your new pet examined by a veterinarian within 7 days of the adoption. The Vet can check your pet’s health and give you valuable information regarding warning signs of illness. With any new pet, it’s possible they may have been exposed to diseases or illness that may not show symptoms for a few days to several weeks. HSHC will not knowingly adopt out a sick animal. Once the adoption is final, all illnesses & fees incurred become the sole responsibility of the owner. Pet Ownership involves medical care, from routine to emergency. Any and all veterinary fees incurred are the sole responsibility of the pet owner. The Humane Society of Henderson County does not routinely test for Heartworms, FIV, FIP, or FeLV. All testing is the responsibility of the new owner.
Initial to agree.
6. Puppies and kittens do not receive their full series of vaccines at the shelter and must be vaccinated by our vet to complete the vaccination series as soon as possible. Vaccines must be given in a series to be complete, which normally requires 3 vaccines 3 weeks apart, or as recommended by your veterinarian. Failure to fully vaccinate your pet puts it at risk of contracting contagious and often fatal diseases.
Initial to agree.
7. I understand that I am required by Kentucky State Law to have my animal vaccinated yearly by a licensed veterinarian against rabies beginning at 4 months of age.
Initial to agree.
8. I agree to abide by all state and local city/county laws & ordinances pertaining to the containment and care of this animal, including, but not limited to, care, city/county license, noise, odor, confinement, and control. City/county tags are available in our office at $2 plus tax.
Initial to agree.
9. It is your responsibility as the foster/adopter person(s) to maintain and secure your animal(s) to ensure they do not reproduce prematurely and illegally while awaiting their vet appointment to alter. If a dog/cat is pregnant at time of spay appointment, all decisions will be made by the Humane Society. Any puppies and/or kittens born while still in foster will be the sole ownership of the Humane Society. KY STATUTE 258.255 Confinement and control of female dog when in heat. Every female dog in heat shall be confined in a building or secure enclosure in such a manner that the female dog cannot come in contact with a male dog except for a planned breeding.
Initial to agree.
10. I agree to feed animal appropriate, age appropriate, healthy, edible food to this animal daily; to provide clean drinking water at all times; and to provide it with adequate shelter from the elements, including adequate shade, even if outside temporarily.
Initial to agree.
11. I agree that a home visit may be performed by an HSHC employee at their discretion.
Initial to agree.

12. I understand that I can not stop payment on my check or credit card. If I do so, a complaint will be filed with the County Attorney. Returned checks will be turned over to the County Attorney for prosecution. Court fines, fees and additional charges may be associated with these actions.
Initial to agree.
13. In the event that you are no longer able to keep this animal, you must return this animal to the Humane Society of Henderson County *NO EXCEPTIONS* . You may not sell, give away, abandon, kill or surrender to any other facility, regardless of where you live or the distance from HSHC.
Initial to agree.
14. HSHC reserves the right to repossess the animal in the event of false information provided by the adopter on this application or the home is found to be injurious to the health or safety of the animal
Initial to agree.
15. THE HUMANE SOCIETY OF HENDERSON COUNTY DOES NOT AGREE WITH DECLAWING. Please research the procedure thoroughly prior to making such a decision. Please research the alternatives available, such as behavior modification, scratching posts, and nail caps.
Initial to agree.
By signing, I do hereby state that I am at least 18 years of age and have read, understood and agree to all the terms and conditions of this contract.
Signature
Date

Month Day Year
Date
Should be Empty:

Please review the application and ENSURE ALL INFORMATION IS COMPLETED AND LEDGIBLE without phone numbers, email, and vital information missing.