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Halfway Home Adoption Application
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Email
*
Your email
Is there a specific cat or dog that you’re interested in adopting?
Your answer
Full name:
Your answer
Address:
Your answer
Phone:
Your answer
Have you adopted from HHAR before?
Yes
No
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Are you a first time pet owner?
Yes
No
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How many adults are in the household, including yourself?
Your answer
How many children are in the household, and what are their ages?
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Do you understand that children MUST be supervised when they interact with new pets?
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Does anyone in the household have a known allergy to dogs or cats?
Yes
No
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Is everyone in the household in agreement with the decision to adopt a pet?
Yes
No
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Do you own or rent your home? If you rent, please include your property manager’s name and phone number. By providing this information, you are allowing HHAR to contact your property manager.
Your answer
What type of home do you live in (apartment, single family home, etc)?
Your answer
For dogs/puppies, do you have a fenced-in area, or access to a fenced-in area for exercise time?
Your answer
When the dog/puppy is outside, how do you plan to supervise it?
Your answer
Please describe the activity level of the household, ie active, noisy, quiet, average
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How many animals are in the household?
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If there are any other pets that will be interacting with the animal you are interested in adopting, please specify:
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Are these pets up to date on vaccinations and annual exams?
Yes
No
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Are these pets on heartworm prevention?
Yes
No
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Are these pets on flea/tick prevention?
Yes
No
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Are these pets spayed/neutered? If not, please explain.
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Have you ever rehomed or surrendered a pet? If yes, please explain.
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If you have had a pet/s in the past, why do you no longer have them?
Your answer
How do you discipline your pets?
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Veterinarian Information: By providing this information, you are giving HHAR permission to contact your veterinarian for reference. Veterinarian’s name, Clinic Name, Address, Phone number
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Where will the pet spend the day?
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Where will the pet spend the night?
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Where will the pet spend time when home alone (crated, single room, etc)?
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On average, how much time will the pet spend alone?
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Who will have primary responsibility for this pet’s daily care?
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Who will have financial responsibility for this pet?
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Are you willing to contact HHAR immediately if your pet gets lost?
Yes
No
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Are you willing to let a representative of HHAR visit your home by appointment?
Yes
No
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Do you agree to provide healthcare by a licensed veterinarian? Including annual exams, preventions, emergencies, etc?
Yes
No
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Are you able to commit to be this pet’s family for the remainder of its life, which could be 10-20 years?
Yes
No
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Please list 2 personal references:
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