Adoption Application - PetSavers of Shreveport, LA

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Pet Savers Adoption Application v.2

Please fill out all required fields

Step 1 of 2 - About You

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Name
First Last
Email
Address
Street Address Address Line 2 City State ZIP / Postal Code
Phone 1
Phone 2
Name of Employer
Employer Phone
Living Circumstances
Tell us about your home life
Housing Type*
- House
- Condo
- Apartment
- Mobile Home
- Farm
Do You*
- Own
- Rent
- Live with Family
- Live with Roommates
Landlord's Name
First Last
Landlord's Phone
Is a pet deposit required?*
- Yes
- No
How many adults live in your household?*
How many children live in your household?*
If there are children, what are their ages?
Are all members of your household supportive of this adoption?*
- Yes
- No
Does anyone in your household have any known allergies to animals?*
- Yes
- No
Are you active military duty?*
- Yes
- No
Pet History

What experience do you have with pets?
Pet 1
Name
Cat or Dog
Spayed or Neutered?
Current or previous pet?
Pet 2
Name
Cat or Dog
Spayed or Neutered?
Current or previous pet?
Pet 3
Name
Cat or Dog
Spayed or Neutered?
Current or previous pet?
Pet 4
Name
Cat or Dog
Spayed or Neutered?
Current or previous pet?
If none are listed above, is this your first experience with a pet?*
- Yes
- No
Have you previously adopted from us or another agency/shelter?*
- Yes
- No
Have you ever given away or returned a pet/animal for any reason?*
- Yes
- No
If yes, why?
Why do you want a pet?
- Family Pet
- Guard Dog
- As a friend for another pet
- Gift
- Other
What is your other reason?
Veterinarian Information
It is REQUIRED that you have a vet before Pet Savers can adopt an animal to you. We will be contacting your veterinarian for basic records on current and previous pets (vaccine history, heartworm prevention). Your vet may require your permission to release this information. Please notify them we will be calling, otherwise your application may be denied.
Name*
First Last
Name of veterinary hospital*
Phone*
What is the EXACT name you are listed at under your vet. We call and verify for all adoptions*
First Last
Information on current pets
Are your pets current on their vaccinations?*
- Yes
- No
Are your pets on heartworm preventative?*
- Yes
- No
Please explain why heartworm preventative is important:
Briefly explain how pets get heartworms.
What brand of heartworm preventative do you use or have you used in the past?
How often do you give heartworm medication?
Pet Details
What is the pet's name while at Pet Savers?
Cat or Dog
For Dog Adoptions
Do you have a fenced yard?
- Yes
- No
How will you confine this pet to your yard?
Where will the dog be kept during the day?
Where will the dog be kept at night?
How many hours a day will the dog be left alone?
For Cat Adoptions
Cat will be:
- Indoor Only
- Outdoor Only
- Combination
Do you plan to declaw?
- Yes
- No
- Unsure
Would you like information about alternatives to declawing?
- Yes
- No
How many hours a day will the cat be left alone?
Do you have a plan to introduce the cat to your household?
- Yes
- No
- Unsure
References
Name of First Reference
First Last
Phone
Email
Name of Second Reference
First Last
Phone
Email

Statement of Understanding
Adoption Agreement*
- I understand that the shelter environment often induces stress in animals. If the animal has behavior problems that I am not sure how to manage, I will contact Pet Savers for information and resources or seek professional assistance. I also understand that it may take 3-6 months for a pet to completely adapt to a new home and family.
- I understand the daily time commitment needed to properly care for this animal and am capable of providing such care.
- I understand that if I adopt a puppy that has not already been surgically sterilized, I must have the animal surgically sterilized before the animal reaches eight months of age and ideally at 5 months of age or Pet Savers may reclaim my pet.
- I understand that this is a lifetime commitment of 10-20 years and I am responsible for annual, monthly and unforeseen veterinary care, including monthly heartworm preventative.
- I understand, should I not be able to provide for his or her care, that I will not surrender, sell or otherwise list my pet as available for re-homing to anyone, without first consulting and notifying Pet Savers.
I understand and agree to each of the previous statements. Select the checkbox to acknowledge your understanding.
Consent*
I agree to the Adoption Agreement.
Name
This field is for validation purposes and should be left unchanged.

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