Adoption Questionnaire

1
Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.Our primary means of communication is text message or Facebook messenger. We do not call.
cell phone number
3
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Email* This field is required.
example@example.com
5
Which pet are you interested in adopting?For faster processing, please list specific animal name/description in the other field.
Cat
Dog
Kitten
Puppy
Other
6
Which pet are you interested in adopting? Please list animal’s name, description, foster’s name, etc. * This field is required.If you are not applying for a specific pet, please describe what you are searching for such as kitten, adult cat, barn cat, puppy, small dog, large dog, Guinea pig, rabbit, etc.
7
Please select all that apply to your current household.* This field is required.Explain anything else in other.
No pets at this time. That’s why I’m filling out this questionnaire.
Already have pets and looking to expand the pack.
My cats are spayed/neutered.
My dogs are spayed/neutered.
I like animals more than people.
I have an intact dog or cat with an explanation in the “other” option.
Spay and neuter should be required.
I have a fenced in yard.
I have lots of land.
My pets sleep in the bed with me.
My pets lounge on the sofa.
I live near a park.
I’m an experienced bunny owner.
I’m a new bunny adopter.
Guinea pigs?!
My rabbits are spayed/neutered.
Other
8
Do you own or rent your household?* This field is required.
Own
Rent and can have pets
9
What do you think about veterinary care?* This field is required.Select all that apply. If you have a current vet, please put their name in the other field.
Every year for a check-up.
Only when they are sick.
I have my vet’s cell phone number.
Only when they need vaccines.
I love my current vet and can’t wait to show them my new pet.
I buy my own vaccines but go to the vet when my pet is sick.
Heartworm prevention is worth every penny.
Other
10
Are you financially prepared to care for a pet?* This field is required.Think about supplies like kennels, litter boxes, collars, leashes, food, veterinary care, toys, etc.
YESNO
11
Adoption donations are $250-500 (unless otherwise noted) for dogs/puppies, $125 for cats/kittens, $100 for rabbits, and $50 for Guinea Pigs. The donation helps cover spay/neuter, microchip with free registration, vaccines for dogs/cats (initial set based on age, may need more boosters with your vet), intestinal parasite screening and deworming, FeLV testing for cats/kittens, heartworm testing for dogs (if over 6 months & positive dogs will be started on treatment), and current on heartworm/flea prevention.* This field is required.Adoption donations are NON-REFUNDABLE.
I understandI do NOT understand
12
Adoption donations may change with increased medical and supply expenses. Payment required at adoption. No refunds.* This field is required.
I understand there are no refunds and my donation goes to support other animals in need.No
13
We accept cash, check, PayPal, or Credit Card. If using PayPal or Credit Card, please add an additional $5 per transaction to cover the fees. http://paypal.me/katvetsnr* This field is required.Adoption donations are NON-REFUNDABLE.
Cash
Check
PayPal (plus $5 transaction fee)
Credit Card (plus $5 transaction fee)
14
I understand that Kat Vet makes no guarantees, expressed or implied, about the animal’s health. I am aware that this animal may have been exposed to contagious or infectious diseases. I am aware this animal may have been injured prior to rescue by Kat Vet or accidentally during our care. Despite veterinary care already provided and Kat Vet’s best efforts to ensure he/she is healthy and sound, unknown conditions may exist. Kat Vet is not responsible for any health problems that may arise. I agree to care for the animal should he/she develop a health problem. I understand that I am responsible for payment of the care provided by the veterinarian of my choice.* This field is required.
I understandI do NOT understand
15
I understand that Kat Vet makes no guarantees, expressed or implied, about the animal’s temperament. Kat Vet is hereby absolved of any liability and shall not be held responsible for any bodily injuries, property damage, or other damage that the adopted animal may cause.* This field is required.
I understandI do NOT understand
16
I agree to contact Kat Vet about any medical concerns within a month of adoption. I agree to contact Kat Vet prior to euthanizing my new pet. This is not a guarantee that Kat Vet can help the situation but we would like to try if possible.* This field is required.
I understandI do NOT understand
17
Reference Name* This field is required.Someone that will say nice things about you.
First Name
Last Name
18
Reference Phone Number* This field is required.Someone that will say nice things about you.
Area Code
Phone Number
19
Is there ANY reason you would NOT keep your pet?* This field is required.
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20
What is your opinion of heartworm prevention?* This field is required.
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21
What is your opinion of declawing cats?* This field is required.Answer even if you are interested in a dog or bunny.
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22
I understand that scratching is a natural behavior and I will provide appropriate outlets to allow my cat to act upon this instinct. I agree that declawing is NOT in the best interest of my cat and should NOT be performed.* This field is required.
I agreeI do NOT agree
23
If you could no longer care for your pet, what would you do with him/her?* This field is required.
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24
What else would like to tell us about yourself?* This field is required.Who are you? Why do you want to adopt? Your favorite food? Your social media link? Something, so we can get to know you a little better.
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