HAA Adoption Application & Agreement
Adoption Application
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Email *
Name of the DOG or PUPPY are you considering for adoption? If you are not sure yet, please put looking for a ... whatever type (breed or size) you would like. Also, if there are multiple ones you are considering, please list all.  *
Your First and Last Name: *
Phone: Home & Cell # with the area code *
Full Address with the City, State, and Zip code *
Employer/Employment Status: *
Please list the names and ages of all persons living in your home. *
Does anyone in your family have allergies? If so, what will you do if a family member is allergic to this dog? *
Will this be an inside dog or outside dog? *
Where will the dog be when the owner is home? *
Where will the dog be while home alone? *
Where will the dog be at night? *
How will the dog be cared for if owner is vacationing or has to be away? *
Do you have a fenced yard? (this is not necessarily a requirement) *
If no, how do you plan to let the dog out and keep the dog safe from traffic or running away?
How close do you live to a street or road?
Do you own your home or rent?   *
If you rent, please list the landlord's name and phone #.
What pets are currently living in your home and their names? *
Are your pets indoor or outdoor pets? *
Required
Name and phone # of your veterinarian or vet clinic? *
At the vet clinic, whose name is your current pet(s) are listed under? *
Have you ever adopted a pet? *
 If yes, when and from where?
Do you agree to have a shelter representative visit your home prior to adoption? *
How did you hear about us? *
ADOPTION AGREEMENT
A printout of this application/agreement will need to be signed when you pick up your new fur baby.

I agree to keep the pet on heartworm preventative.
Clear selection

For and in consideration of $ _________, and the mutual promises contained herein, the parties agree to the following terms of adoption, to wit:

*ADOPTER understands and agrees that the dog referred to as __________________________ will remain on vet-recommended heartworm prevention for the duration of his/her lifetime. 

*ADOPTER understands and agrees that if for any reason at any time, the said dog needs to be rehomed, Hardeman Adoptable Animals must be consulted. At that time it will be determined if the dog can be rehomed by owner or returned to HAA.  IF this is within the first two weeks, the adoption fee will be refunded IF requested. 

*ADOPTER understands that HAA has represented this dog by disclosing all known information. This includes medical and behavioral information. In most cases, the dog's breed and age are unknown or it is a guess based on physical characteristics. ADOPTER further understands that HAA is not responsible for any medical or behavioral conditions that occur after adoption. 

In accordance with the "Tennessee Spay/Neuter Law" as outlined in T.C.A. Section 44-17-502, et seq., Hardeman Adoptable Animals, Inc., and/or the Hardeman County Animal Control Shelter, hereinafter referred to as "agency," does hereby offer for adoption and new owner does hereby accept for adoption the identified dog:

1. For any dog that has not been spayed or neutered, the new owner shall have the above-identified dog spayed or neutered by a licensed veterinarian:

 (a) Within thirty (30) days of the date of the adoption, if such dog is sexually mature; or

 (b) Within thirty (30) days after the dog reaches six (6) months of age, if the dog is not sexually mature at the time of adoption.

Nothing in this section shall preclude the spaying or neutering of a sexually immature dog at the discretion of a licensed veterinarian with the consent of the new owner.

2. If the dog being adopted has not been spayed or neutered, the new owner may request and shall receive a refund of one hundred dollars ($100) from the agency upon providing confirmation of the spaying or neutering.

If the new owner fails to have the above-identified dog spayed or neutered within the time frame established by Section 44-17-502, or if the spaying or neutering is timely performed, but the new owner fails to request the return of the deposit within an additional fifteen (15) days after the date by which the spaying or neutering is required to be performed, such deposit shall be forfeited to the agency.

3. If the adoption fails to comply with the provisions set forth herein and outlined in T.C.A. Section 44-17- 502, et. seq., the agency may file a petition with a court competent jurisdiction seeking compliance and/or requesting the return of the dog to the agency from which it was adopted.

Adopter's Name (PLEASE PRINT) ____________________________________

Adopter's Signature_______________________________________________

Date ___________

Agency Representative____________________________________________

Date ___________


*Note - " Tennessee has a state law (§ 44-8-408) makes it a crime to allow a dog to run at large. The dog must be under control at all times if out. "
By submitting this application, I certify that the information given is true and that I recognize any misrepresentation of the facts may result in my losing privilege of adoption. I authorize investigation of all statements on this application.
If filling out online, when you have successfully submitted the application you will see "Thanks for submitting your adoption application."
I have read and understand the adoption agreement. I further understand that if I feel I cannot keep the dog for ANY reason I MUST return him/her to the animal shelter, and MUST NOT sell/give him/her to anyone else. *
If filling out online, when you have successfully submitted the application you will see "Thanks for submitting your adoption application."
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