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Safe Haven Animal RescuE
To apply for pet adoption, please fill out the form below.
Safe Haven Animal RescuE reserves the right to refuse adoption to anyone.
Name(s) of Animal(s) you are applying for *
First and Last name
Your answer
Your Name *
First and Last name
Your answer
Birthdate *
MM
/
DD
/
YYYY
Phone Number *
Your answer
Email *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Do you currently have pets? If so, please tell us about them (type, breed, age, gender, altered, etc.) *
Your answer
Have you had pets in the past? If yes, please tell us about them (type, breed, gender, altered, health, etc.). Please also explain why you no longer have them. *
Your answer
Why do you want a pet? *
Required
Have you ever surrendered an animal? If yes, please explain the reasoning. *
Your answer
Who is your current vet? If you do not have one, who will you use? If current Vet is less than two years, list previous vet used. *
Please list name, address, phone number, and how long you have been with them.
Your answer
Are you familiar with Heart Worm Disease? *
Do you use/plan to use a heart worm preventative? *
What heart worm preventative do/will you use? *
Your answer
Do you rent or own? If you rent, what are the requirements of your lease for having a pet? *
Your answer
If you rent, please provide your landlord's name and phone number. *
Your answer
Do you have a fenced in yard? *
How will you keep your pet confined on your property? *
Required
Please tell us about your home. Park close by? Where will your new pet walk and exercise? *
Your answer
What activities will you include your new pet in? Hiking, running, travel, etc.? *
Your answer
How will you secure your pet when traveling in a vehicle? *
Required
Who lives in your home? Please list their names, ages, and relationships? *
Your answer
Who will be responsible for the care of this pet? *
Your answer
Do you or anyone in your home have allergies to animals? *
Does everyone in your home agree to getting a new pet? *
Where will your pet stay during the day? During the night? *
Your answer
How many hours a day will your pet spend alone? During this time, how and where will they be kept? *
Your answer
If you go out of town or need to evacuate or relocate, what will you do with your pet? *
Your answer
What will you do if your pet chews or claws on furniture, shoes, siding or shows other destructive behaviors? *
Your answer
What reasons would you consider giving up your pet? *
Your answer
Do you agree to allow Save Haven Animal RescuE to perform a home check before the adoption in final? *
Please list two personal references (one not being a family member) we may contact. Please give name, phone number, relationship, and years known. *
Your answer
Any other information you feel Safe Haven Animal RescuE should know.
Your answer
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