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Pet Savers Adoption Application v.2
Please fill out all required fields
Step
1
of
2
- About You
0%
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?
*
1
2
3
4
5
6 or more
How many children live in your household?
*
0
1
2
3
4
5
6 or more
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
Select
Cat
Dog
Spayed or Neutered?
Select
Yes
No
Current or previous pet?
Select
Current
Previous
Pet 2
Name
Cat or Dog
Cat
Dog
Spayed or Neutered?
Yes
No
Current or previous pet?
Current
Previous
Pet 3
Name
Cat or Dog
Cat
Dog
Spayed or Neutered?
Yes
No
Current or previous pet?
Current
Previous
Pet 4
Name
Cat or Dog
Cat
Dog
Spayed or Neutered?
Yes
No
Current or previous pet?
Current
Previous
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
Cat
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.
Email
This field is for validation purposes and should be left unchanged.