Name:
E-Mail:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Phone:
Name and Description of animal you are interested in:
Is this pet for you or someone else?:
Do you have children?:
Children's ages:
Do you rent or own your home?:
Do you have permission from your landlord to adopt this animal?:
Do you live in a house, apartment, condo, townhouse or mobile home?:
Is anyone in the household in the military?:
Is anyone in the household allergic to animals?:
Does everyone in the household know you plan to adopt a pet?:
Any other pets in the household? (describe):
Are your other pets spayed/neutered?:
Pets previously owned:
What happened to them?:
Where will your new pet live and sleep?:
Do you have a veterinarian? Name? :
Do you work outside the home?:
How many hours per day will the pet be left alone?:
Under what circumstances would you not keep a pet? New baby?:
New job?:
Does not get along with other pets?:
Has fleas?:
Is destructive (chews up your shoes, the couch, etc.)?:
Requires costly medical care?:
Would you move to a home that doesn't allow animals?:
Do you have a balcony?:
Do you have a pet door?:
Do you have unscreened windows?:
Is your household activity level quiet/serene, some activity, very active?:
(CAT/KITTEN only) I understand that I will need to provide a SECURE CARRIER to transport the cat/kitten home:
(CAT/KITTEN only) Are you looking for an indoor only, indoor/outdoor or outdoor only pet?:
(CAT/KITTEN only) Do you have supplies to care for a cat/kitten (food, dishes, litter/box/scoop)?:
(CAT/KITTEN only) Are you planning to declaw the cat?:
(DOG/PUPPY only) Are you looking for an indoor only, indoor/outdoor or outdoor only pet?:
(DOG/PUPPY only) Do you have a yard?:
(DOG/PUPPY only) Is your yard completely fenced?:
(DOG/PUPPY only) Or will you chain the dog when it's outside?:
(DOG/PUPPY only) Do you have a pool?:
(DOG/PUPPY only) Is the pool fenced off?:
Are you aware of the commitment of time, love, patience, and expense needed for your pet wich could span 15 or more years?:
I have read the above completely and answered honestly to the best of my knowledge (initial):