Animal Adoption Questionnaire
Pet ownership is a serious responsibility. The policy of the Humane Society of Truckee-Tahoe is to ensure that each person who adopts a pet not only is aware of the responsibility, but that each person is willing and able to accept that responsibility morally, physically and financially.

This application is designed to help us make the best placement possible — the right home for each animal and the right animal for your home. The adoption process takes time because we are committed to giving you all the information and support you need to have a successful adoption. We ask for your patience and cooperation in the joyful process of bringing people and animals together.

TO BE CONSIDERED FOR AN ADOPTION TODAY, YOU MUST:

• Be at least 18 years of age.
• Provide a suitable environment for the pet.
• Understand that the Humane Society of Truckee-Tahoe reserves the right to deny any adoption.
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Email *
Are you at least 18 years old? *
Full Name *
Name of pet you're interested in adopting:
Phone Number *
Type of Phone *
Emergency Contact Information (in the event YOU can't be reached): Include first name, last name and phone number. *
Mailing Address (including zip code) *
Full Physical Address (if different than Mailing, including zip code)
Employer
Number of Adults in Home *
Number of Children in Home *
Ages of Children in Home
Do you live with a parent, relative or roommate? *
Does everyone in the home want this animal? *
Who will be responsible for this animal? *
Do you rent or own? *
If renting, does your landlord allow pets?
Clear selection
Landlord's Phone Number/Email
How long have you lived at your current address? *
Are you planning to move in the next 6-12 months? *
If you do move in the future, what will you do with your pet? *
Please list any pets you currently own *
Please list any pets you have previously owned and what happened to them *
Are there any other pets in the home or on the property? *
Veterinarian's Information
Are all of your pets current on vaccines?
Clear selection
Are all of your pets spayed/neutered?
Clear selection
If your pet is not spayed/neutered, why not?
Have you applied to adopt an animal from HSTT before? *
Have you adopted an animal from HSTT before? *
Have you ever turned an animal in to a shelter? (not including a found stray animal) *
If yes, what were the circumstances?
Does anyone in your home have allergies to animals? *
If yes, to what type of animal and how severe?
Are you prepared to provide any necessary medical treatment for your pet? *
Where will your pet be kept during the day? *
Where will your pet be kept at night? *
Who will care for your pet when you go on vacation? *
If your pet gets lost, explain how you will try to find it. *
If you must give up this pet, how will you place it? *
Do you understand your local animal control ordinances, including licensing and limits on the number of animals allowed in a household? *
Will this adoption put you over the legal limit for animals allowed in a household? *
How did you hear about this animal/HSTT? *
Required
Are you ready to take on the responsibility for this animal's entire life? *
Is there anything else you'd like to share about yourself, your home or what you're looking for?
By typing your name below and submitting this application you agree:   (1) The Humane Society of Truckee-Tahoe (HSTT) reserves the right to check on the welfare of my animal and inspect the premises where the animal will be housed. (2) I hereby release to HSTT all veterinary records of all animals I have had or currently have. (3) I certify that all the information in this application is true and correct and understand that false information may void this questionnaire. (4) I also understand that failure to comply with the conditions set forth in the application contract could result in the refusal of future adoptions from the HSTT. *
Most HSTT animals are microchipped through 24PetWatch/Pethealth Inc., which offers free lost pet services, as well as microchip membership and insurance services.
If you check NO to the following question, Pethealth Inc. will not be able to contact you via email in the event that your microchipped pet goes missing. You may amend or withdraw your consent at any time by contacting 24PetWatch.
Do you consent to Pethealth Inc. collecting and using your personal information for the purpose of contacting you via email and/or telephone communications regarding lost pet services and promotional offers? *
Do you consent to release of your name and phone number to anyone that finds your pet? *
I/we hereby grant HSTT permission to use said person’s name, likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken by or made on behalf of HSTT.  I agree that HSTT has complete ownership of such media, including the entire copyright, and may use them for any purpose consistent with HSTT’s mission or promotional needs. I agree that I/we shall not receive any compensation for the use of such media and hereby release HSTT, its agents and assigns, from any and all claims that arise out of or are in any way connected with such use. *
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