Name of adopter(s):
Mailing address:
City, State, Zip:
Email:
Physical address (if different from mailing address):
Home phone: Work phone: Cell phone:
Does anyone in the home have allergies to animals?
How many people live in the household? Children's ages:
Who in the household will be responsible for caring for the animal and their age?
4. Veterinary Information
1. Why did you decide to get a new cat?
2a. Please explain your reasoning for this decision:
3a. Please explain your reasoning for this decision:
4. Under what circumstances would you not be able to care for this cat?
5. How do you plan to discipline this animal and/or discourage unwanted behavior (i.e. jumping on counters, scratching furniture, etc.)?
6. What is your reason for choosing this particular animal?
1. Why did you decide to get a new dog?
2. Please provide a sentence or two on what you know about heartworm disease.
3. How often will your new dog receive heartworm prevention and heartworm testing?
5. How do you plan to exercise this dog?
6. How do you plan to discipline this dog?
7. Under what circumstances would you not be able to care for this dog?
8. Where will this dog sleep?
10. How many hours will this dog be alone each day (average)?
11. What is your reason for choosing this particular animal?
1. How often will you bring your new pet to the vet for regular checkups and vaccinations?
2. How much do you plan on spending yearly on medical care for this pet?
3. How much would you be willing to spend on a medical emergency for this pet?
4. If you had to move, how important is it that your new home allows pets?
5. How long do you expect your new pet to be a part of your life?
In an emergency, if something should happen to you and/or you are no longer able to care for the pet(s), who will be the caretaker of your animal(s)?