Middleburg Heights Division of Animal Care and Control Adoption Application

Middleburg Heights Division of Animal Care and Control Adoption Application

7375 Engle Road - Middleburg Heights, OH 44130 - https://middleburgheights.com/police/animal-control/
The mission of the Division of Animal Control is to promote and protect the health, safety and welfare of people and pets in the city of Middleburg Heights. By providing and maintaining quality care and behavior assessment for homeless and/or abandoned animals from Middleburg Heights Ohio, animals can then be adopted into a welcoming, loving forever home.

We provide the best care we can. Some animals may come with requirements that we do our best to identify. Vetting animals for adoption is no guarantee of any particular behavior and is completed to the best of our ability. Our intent is to place animals into warm, safe and loving forever homes.

We reserve the right to deny any application or applicant for any reason.

Adoption Fee is collected at time of pick-up.

Cats and Dogs: $75

Kittens and Puppies: $100

Small mammals and birds: $25-$50

Please be patient with us in getting back to you regarding your application. It may take up to 24 hours for a response. Thank you!
Date of Application:*

MonthDayYear
Date
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Home/Mobile Phone Number*
Please enter a valid phone number.
Can we text you at the phone number you provided regarding your application status?

YesNoNo, this is a home phone
Name of Employer*
Occupation*
Work Phone Number
Please enter a valid phone number.
For what animal are you applying?*

Kitten/CatPuppy/DogOther
What is the name of the animal(s) for which you are applying? (If unsure, type NA)*
Have you ever adopted an animal from a rescue or shelter?*

YesNo
Have you ever had an adoption application rejected by a rescue or shelter?*

YesNo
Have you ever given up an animal?*

YesNo
If you have given up an animal, please explain. If not, type N/A.*
How many adults reside in the adopting home?*
How many children reside in the adopting home?*
What are the children's ages in the home?
Is anyone in the adopting home allergic to animals?*

YesNo
If someone is allergic, how will that be handled? If not, type N/A.*
Why do you want to adopt this animal?*
What would be the most important responsibilities in owning this animal?*
Under what circumstances would you return this animal?*
Do you currently have any animals in the household? If so, please list the name, breed, and age of each animal.*
What precautions would you take to properly introduce your new pet to the other animals in the house?*
Who will be the primary caretaker of this animal?*
If a disciplinary or behavior problem arises, what steps would you take to resolve the issue?*
Are you adopting for yourself or as a gift for someone else?*

I am adopting for myselfI am adopting as a gift
If you were to move in the future, what would you do with your pet(s)?*
What is the name of the veterinary clinic that you use for your pets?*
What is your veterinarian's name?*
What is the phone number of the veterinary clinic?*
Please enter a valid phone number.
What is the name of the owner under which the records are listed?*

First NameLast Name
Date of last vet visit:

MonthDayYear
Date
Please list the veterinary care you plan to provide for your animal (including shots, flea control, etc...)*
Do you have a different veterinary clinic in mind for your new pet? If yes, please list name and phone number.*
Do you rent or own your home?*

OwnRent
In what type of residence do you reside?*

HouseTownhouseDuplexApartmentOther
Landlord Name*

First NameLast Name
Landlord Phone Number*
Please enter a valid phone number.
Are pets allowed?*

YesNoUnsure
Is there an additional charge for pets?*

YesNoUnsure
Will your cat be allowed:*

Indoors OnlyOutdoors OnlyIndoors and Outdoors
Do you plan to declaw your cat?*

YesNoUnsure
Where will your pet stay when you travel?*
Where will your pet stay when you're home?*
Where will your pet stay when you're NOT home?*
Will anyone be home during the day?*

YesNo
How many hours per day are your pets usually left unattended?*
Agreement

Adoption fees are non-refundable under any circumstances. I attest that all of the information contained herein is true and accurate to the best of my ability. I give permission for the Middleburg Heights Division of Animal Care and Control to contact anyone in this form. I agree to abide by all of my City Ordinances in relation to this animal. If approved, I understand there is a subsequent binding contract to be signed.
Signature

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Middleburg Heights Division of Animal Care and Control Adoption Application

Agreement