Pet Adoption Application Form

Adoption Application, Contract and Waiver

Perspective Pet Parent*

First NameLast Name

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Name of pet you want to adopt*

Do you own any pets?*

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other animals and cats?

Are your other pets spayed/neutered?*

YesNo

If not, why?

Can you provide proof of other pets being up to date on vaccines?*

YesNo

If not, why?

Please provide your veterinarian's name and phone number, or would you continue to use us as your primary veterinarian:

Do you own or rent your home?*

OwnRent

Do you have a yard?*

YesNo

If "Yes" to the above, is it fenced? please describe

What is your landlord's pet policy?*

Adoption fees include all kitten/puppy vaccines, deworming, combo test (for kittens) and spay/ neuter. It is required that the pet be brought back to us every 3 weeks until they are finished with all kitten/puppy vaccines and then again for their spay/neuter. Can you bring them back on time for everything required? *

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

YesNo

Do you plan to keep your pet's vaccinations up to date with your vet?*

YesNo

If your pet becomes ill, would you be willing and able to cover medical costs?*

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

If you answered "Yes" to the above question, please provide detail:

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

Will you crate your pet?*

If it's a kitten you're adopting, will it be indoor/outdoor, or strictly indoor?*

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

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

Under what circumstances would you consider rehoming your pet?*

*By virtually signing below, I agree that if under any circumstance I have to rehome, I will contact Richmond Veterinary Clinic beforehand for possibility of surrender.

*By hitting the submit button, I agree to the adoption fee of $200 for cats and $300 for dogs, which will include vaccines, deworming, and spay/neuter.

Signature of Potential Pet Parent*