Adoption Application
Questions marked by * are required.
1. Name of Pet and ID#, if known, you are interested in: *
2. Your Name: *
3. Telephone Number: *
4. Email address: *
5. Place of employment & job title of all adults in your home: *
6. Will you agree to a home visit? *
  • Yes
  • No
7. About your home ... *
  • I Own
  • I Rent
8. 8. If you rent, would you agree to landlord verification that pets are allowed and if a pet deposit is required? *
  • Yes
  • No
  • Does not apply
9. 9. How many people live in your household? *
10. 10. What are the ages of the people in your household? *
11. 11. If you have children in your household, have the been around pets before? *
  • Yes
  • No
  • Does not apply
12. 12. Will you monitor young children around your new pet to assure a smooth transition? *
  • Yes
  • No
  • Does not apply
13. 13. Are there any other pets in your household, including exotics? *
  • Yes
  • No
14. 14. If yes, please list each pet in your household: type; breed; gender; age; temperament *
15. 15. Are all pets in your household current on their vaccination? *
  • Yes
  • No
  • Does not apply
16. 16. Are all pets in your household spayed or neutered? *
  • Yes
  • No
  • Does not apply
17. 17. If you answered no to either of the above 2 questions, please explain. If you answered yes, please enter N/A *
18. 18. Can you provide vet records? *
  • Yes
  • No
  • Does not apply
19. 19. Please provide the name and phone number of your veterinarian *
20. 20. Tell us about your yard: *
  • Fenced Front & Back
  • Fenced Back only
  • Fenced Front only
  • Invisible Fence
  • No Fence
21. 21. Tell us about your fence, type and height: *
22. 22. Do you have a pet door? *
  • Yes
  • No
23. 23. If yes, where does your pet door lead? (if no, enter N/A) *
24. 24. If you don't have a fenced yard, how do you plan to exercise your pet? *
25. 25. Tell us about your pet's living arrangements *
  • inside only
  • outside only
  • indoor/outside supervised
  • Indoor/outdoor unsupervised (pet door)
  • crated indoors when alone
  • free roam of home when alone
26. 26. Do you live on a busy street? *
  • Yes
  • No
27. 27. On average, how long will your pet be left alone each day? *
28. 28. Today's Date: *
29. 29. If I am selected & I adopt this pet, I agree to seek medical attention immediately if necessary; to comply with state, parish & city laws regarding yearly vaccinations; to never let this pet roam free; to love and care for this pet providing a great home for my new family member. I understand an adoption contract and adoption fee will be required. *
  • Yes
  • No
30. 30. How did you learn about this pet? *
  • Facebook page
  • RescueMe
  • Adopt-a-Pet
  • PetFinders
  • Craigslist
  • other
31. 31. If you answered "other" to question #30, please tell us how your learned of this pet for adoption.
32. 32. What is your mailing address? What is your physical address if different from your mailing address? *