Adoptionadmin2022-10-19T16:49:45-05:00 Adoption Form Step 1 of 4 25% Name of Dog/Cat Date MM slash DD slash YYYY Applicant Name First Last Date of Birth MM slash DD slash YYYY AgePlease enter a number greater than or equal to 21.Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneEmail Occupation Employer Adopting a pet brings a lot of responsibility, including annual visits to the veterinarian, vaccinations, and possible emergency care. This is more expensive than many people realize. Are you aware of and prepared to assume the financial responsibilities for your newly adopted pet? Yes Household InformationDo you rent or own your home? Rent Own How long have you lived there? What type of home is it? House Condo Trailer Apartment How many people live in the home?Are they family or friends? Landlord's Name Landlord's Phone NumberDo you have your landlord’s permission to keep a pet? Yes.Other People Living in HomeNameAge Add RemoveHave you owned a pet before as an adult? Yes No What type of pet(s)? What happened to him/her/them?Do you currently have other pets? Yes No Please list your other petsNameType/BreedAgeSexSpayed/Neutered? If no, why not? Add Remove Veterinarian Veterinarian's Phone NumberI give my permission for Humane Society of Calloway County (HSCC) to contact my veterinarian in order to verify that I have acted responsibly concerning the medical care for my animal in both consistency and in financial good standing. I agreeIs this the same vet that saw your previous/current pets? Yes No Contact info for all other vets: Are you aware of the shots required for your pet? Yes No Are you aware that all animals adopted from HSCC MUST be spayed or neutered with NO exceptions? Yes What are you prepared to spend on your pet yearly? (vet care, food, groom, heartworm/flea/tick prevention) Where will your new pet live? Please Check All that Apply Indoor Indoor and Outdoor with Supervision Mostly Outdoor Outdoor only At the Barn Tied Up Outside Running Free In a Fenced Yard Kennel During a typical day, how many hours will your pet remain unsupervised?How do you plan to confine the pet to your property? Where will your pet be kept during the day? Where will the pet be when you are out of town? “Accidents” can happen due to training, behavior, age, physical condition and being in a new environment, are you willing to tolerate a few housetraining accidents and help the pet by trying different solutions? Yes No I acknowledge that all of the information on the entire Application is true and correct. I agreeDate MM slash DD slash YYYY Additional Comments Δ
