Chesapeake Humane Society Adoption Application
1149 New Mill Dr, Chesapeake, VA 23322
757.546.5355
www.ChesapeakeHumane.org

Applications are reviewed and considered in the order they are received. Once an adoption counselor reaches out via phone or email, applicants have 24 hours* to meet all adoption requirements and respond. After 24 hours*, the application becomes inactive and the next application is considered. If your application expires, it can be transferred to another adoptable pet at our shelter for consideration – you do not have to fill out another application.

Our adoption counselors will answer any questions you have and help guide you to find the perfect fit for your household.

* Pets in very high demand may have shorter timeframes which will be defined in their adoption profile. Pets in high demand may include litters of puppies or kittens, small dogs, and purebred pets.

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Pet Requested (select one pet unless intending on adopting two) *
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
State *
Zip Code *
Phone Number *
Email Address
Driver's License/ID Number *
Do you own or rent your residence? *
Please list names and ages of all other household members (include roommates, spouse, children, etc). *
Please list all current pets that you have in your home. Please include pet's name(s), breed, age, sex, and if your pet is spayed or neutered. *
If you currently have pets, which veterinarian do you currently use for check-ups, vaccinations, etc.? (Please provide clinic name and phone number)                                                                     *
Where will this pet live? Check all that apply
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Do you qualify for any potential adoption discounts? (Additional criteria may need to be met to qualify for discounts)
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By signing below, I agree that the answers I have provided are true to the best of my knowledge. Additionally, I certify that I have never been convicted of animal cruelty, neglect, or abandonment. *
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