Pet Adoption Application
How Long at Present Address?*
Do you Rent or Own?
Do you have a fenced yard?*
Fence Height (in feet)
Why do you want to adopt an animal?*
Has your entire family discussed adopting a pet?*
Do you have children under 18 years of age?*
How will you handle unwanted behaviors?*
How much time will you allow your new pet to adjust to your home?*
Who will be responsible for taking care of the dog/cat/pocket pet?*
How many hours per day will the dog/cat/pocket pet be alone?*
Where will the dog/cat/pocket pet stay when no one is home?*
Where will the dog/cat/pocket pet stay when you are home?*
How often will you exercise your pet?*
Who will care for your pet when you are out of town (vacation, business trip, etc.)?*
Under what condition(s) would you have to give up your dog/cat/pocket pet?*
Have you ever given an animal away or relinquished it to a shelter?*
Do you have pets in your home now?*
Current Pets* (or type "n/a")
Are all your current pets licensed?*
Are all your pets spayed or neutered?*
Are all your pets up-to-date on vaccinations?*
Do your pets have heartworm and flea/tick prevention?*
Pets you have had in the last (5) years (if not listed above)
Name of Curret Veterinarian Practise
Current Vet's Name
Agreements for Adoption
- I am prepared to make a 10 to 20 year commitment to my cat / dog.
- I keep my dog on a regular routine of heart worm preventative.
- I will provide flea/tick control as needed.
- I will work with my vet and agree on a regular schedule for wellness visits, inoculations, and any other tests we agree are necessary for the health and well-being of my dog / cat.
- I will not chain or tie-up my dog / cat and leave it outside alone. My dog / cat will be and indoor dog / cat and an important members of my family.
- If, for any reason, I am unable or unwilling to keep this dog / cat, I agree to return him / her to the Original Pet Owner. I will not give this dog / cat away, take it to a shelter, place him / her with another person or family.
- I am financially able to provide routine and emergency care for this dog / cat for his / her lifetime. This includes but is not limited to food, boarding (if necessary), regular vet care, heart worm preventative and flea and tick preventative.
Release & Indemnification / No Liability:
All adoptions include spay/neuter surgeries, initial inoculations (vaccinations), microchip implant, FeLV/FIV test or heartworm test, flea prevention, 30-days Shelter Care Pet Insurance, 14 day post-adoption free vet exam (covers cost of exam only). Adopting a pet is a big commitment and may at times require extra patience on the part of every member of the family. In addition, you could incur unexpected costs necessary to keep your new pet healthy.
Upon approval of this application and when your new pet is ready for final adoption, you will be given a contract to sign and your pet will be released to you. We are here to assist in your search and answer any questions you may have. Thank you for choosing the Flagler Humane Society to find your next best friend.
Do you agree with the terms above?
, you are acknowledging your agreement with the statements above.