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Adoption Form
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* Indicates required question
Animal Interested In:
Your answer
Date of application
*
MM
/
DD
/
YYYY
First and last name
*
Your answer
Address
*
Your answer
City
*
Your answer
Zip code
*
Your answer
Phone number
*
Your answer
Email
*
Your answer
How many animals do you have now? What kind/breed? How old?
*
Your answer
Will this pet be inside or outside
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Inside
Outside
Other:
Is this pet a gift?
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Yes
No
Do you have children? If yes, what are their ages?
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Your answer
Will this animal ever be around children?
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Yes
No
Are you getting this pet for your children?
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Yes
No
Do you expect the children to have complete responsibility of this animal?
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Yes
No
What influenced your decision on this animal?
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Your answer
Do you own or rent?
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Own
Rent
Does your rental agreement allow for pets?
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Yes
No
If you rent, please provide the name and number for your landlord/rental company. (If you don't rent, put N/A)
*
Your answer
Do you live in an apartment or house?
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Apartment
House
Do you have a fenced in yard?
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Yes
No
Other:
Is everyone in the home on board with having a new fur friend?
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Yes
No
If adopting a dog, do you have ample space and time to exercise them?
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Yes
No
Other:
Does anyone in your home have allergies to cats/dogs?
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Yes
No
Other:
Which vet do you use or have you used in the last year? (Please include name and location)
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Your answer
How many hours on average will your pet be alone each day?
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Your answer
Do you have a friend or neighbor that can help with the animal should you become ill or have to be away from home for a short period?
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Yes
No
Other:
When you go on vacation, how will your pet be cared for?
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Your answer
If your pet damaged your favorite item, what would you do?
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Your answer
Are you willing to give this animal time and help in adjusting to your home?
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Yes
No
Other:
Have you surrendered or given away a pet in the last 2 years? (if yes, please explain reason)
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Your answer
References
List a minimum of 3 references that can attest to your care of this animal, including their relationship to you. (name and phone number required)
Name, Relationship to you, and Phone number
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Your answer
Name, Relationship to you, and Phone number
*
Your answer
Name, Relationship to you, and Phone number
*
Your answer
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