PET Adoption Application
Name
*
Address
*
Home Phone
*
Cell Phone
Email
*
Employer
*
Employer Address
*
Employer Phone
*
Pets owned now
Cat(s)
Dog(s)
Other
If you checked "other," list pets
How long have you owned these pets?
Please Select
less than 6 mos.
less than 1 yr.
1-2 yrs.
2-5 yrs.
5+ yrs
Why are you looking to adopt?
*
Are there other decision-making adults in the household?
*
Please Select
yes
no
Are all decision-making adults looking forward to this addition?
*
Please Select
yes
no
not sure
Are there any children in the household?
*
Please Select
yes
no
sometimes
If you checked "yes", list ages of children
infant
1-3 yrs.
3-6 yrs.
6-10 yrs.
10-13 yrs.
13-15 yrs.
15-19 yrs.
If household member becomes allergic, explain what you will do
*
Check all pet behaviors that you find intolerable
*
elimination
scratching
biting
hissing
fear
shyness
vocalization
none
Have you or would you ever declaw a cat, or debark a dog?
*
yes
no
If you checked "yes," please explain why
When you are out of town, who cares for your pets?
*
May we contact your caregiver?
*
yes
no
not applicable
Caregiver's name
*
Caregiver's number:
*
Veterinarian
*
Vet's number
*
Reference (family) name
*
Reference number
*
Reference (friend) name
*
Reference number
*
Have you ever adopted from a shelter or rescue?
*
yes
no
Have you ever returned a pet that you adopted or purchased?
*
yes
no
not applicable
If you checked "yes, " explain the circumstances
Do you agree to pre- and post adoption home visits?
*
yes
no
don\'t know
Do you agree to have unaltered pet spayed/neutered
*
yes
no
I\'ll try
Do you agree to have all necessary vax, flea/worm treatments, annual vet visit, and all medical care necessary for optimal health and comfort?
*
yes
no
I\'ll try
Which pet(s) are you interested in? Questions/comments?
Submit
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