In which animal(s) are you interested? List by
Petfinder listing name(s) if you know them, or by general
description if you are looking for a type of pet, but don't have
a specific one in mind:
Your Complete Name:
Phone Number (day):
Phone Number (evening):
Occupation; Place of Employment
Please list names and ages of all people (include self) living in the household:
Veterinarian Reference #1: Please include name AND phone number. (Note: application will not be processed without at least one complete vet reference.)
Veterinarian Reference #2: Please include name AND phone number.
What is(are) the name(s) and type(s) of the pet(s) that you take to the above veterinarian(s)?
Have you taken other animals to this vet?
If so, what are their names and types?
Please list the names, ages, and species (dog, cat, etc.) of ALL your current pets. If you do not currently own any pets, please specify "none."
Have you owned cats or dogs in the past that no longer live with you?
If so, what has happened to her/him/them?
Is(are) your current pet(s) fixed (spayed or neutered)?
If any are not, please specify why that is:
Is(are) your current animal(s) on heartworm prevention?
Brand of heartworm preventative that you use?
Do you own your own home?
If you rent, is it a house or an apartment?
If you rent, are pets permitted?
If you rent, please provide your landlord's name and phone number (applications cannot be approved for renters without this information):
Is your yard fenced?
Please specify type and height of fencing:
Will your new dog/cat be an inside animal?
Where will your new pet be kept during the day?
Where will your new pet sleep?
How much time will this dog/cat spend inside the house?
How much time will this dog/cat spend outside the house?
How much time will this dog/cat be alone during the day?
How will you exercise this dog/cat?
What do you intend to feed this dog/cat?
Do you often have other people visit your home?
If so, typical ages/genders:
Are you prepared for the financial responsibilities of yearly veterinary exams, vaccinations, monthly heartworm prevention, regular flea and tick prevention, and other incidental veterinary expenses for this pet?
Are you prepared for the special needs, time, and patience involved in welcoming a new pet into the home?
If you experience a behavioral problem with your newly adopted pet, what will you do?
If you should move, what will happen to this dog/cat?
Will you permit a home visit by an animal rescue group in your town?
By typing my name here, I confirm that the above information is correct and agree to allow my veterinarian (and landlord, if applicable) to verify the information provided above.