Adoption Form
Animal Interested In:
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Date
MM
/
DD
/
YYYY
Name
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Address
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Phone number
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Email
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How many animals do you have now? What kind/breed? How old?
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Will this pet be inside or outside
Inside
Outside
Other:
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Is this pet a gift?
Yes
No
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Do you have children? If yes, what are their ages?
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Will this animal ever be around children?
Yes
No
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Are you getting this pet for your children?
Yes
No
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Do you expect the children to have complete responsibility of this animal?
Yes
No
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What influenced your decision on this animal?
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Do you own or rent?
Own
Rent
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Does your rental agreement allow for pets?
Yes
No
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If you rent, please provide the name and number for your landlord/rental company
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Do you live in an apartment or house?
Apartment
House
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Do you have a fenced in yard?
Yes
No
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Is everyone in the home on board with having a new fur friend?
Yes
No
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If adoption a dog, is there ample space and time to exercise them?
Yes
No
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Does anyone in your home have allergies to cats/dogs?
Yes
No
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Which vet do you use or have you used in the last year? (Please include name and location)
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How many hours on average will your pet be alone each day?
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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?
Yes
No
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When you go on vacation, how will your pet be cared for?
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If your pet damaged your favorite item, what would you do?
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Are you will to give this animal time and help in adjusting to your home?
Yes
No
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Have you surrendered or given away a pet in the last 2 years? (if yes, please explain reason)
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List 3 references that can attest to your care of this animal (name and phone number)
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