Learn How To Do Self-Adoptions The Proper Way.

STATISTICS HAVE PROVEN THAT
75% TO 80% OF PET OWNERS
KEEP THEIR ANIMALS 2 YEARS OR LESS!

If most people were responsible pet owners, we would not have problems such as:

Pounds and shelters filled with homeless, neglected and abused animals.
Thousands of unwanted puppies and kittens being born each year.
Eight million animals are being euthanized each year in our shelters.
Hundreds of free to good home ads placed in local papers each week which puts the pet in life threatening situations such as giving the animal to a buncher. Buncher is a term for people who fraudulently obtain animals for illegal commercial sales. They call on these ads frequently, and yes, they will even buy the animal at a lower price than they can get for its sale.
These are some basic steps to follow for a more responsible adoption of your pet.

Have an application completed by the interested party including name, address, phone number, etc.
Verify information with current I.D. (drivers license) and utility bills (to verify residence).
Secure a vet reference by calling the persons vet on pets they currently own or have had in the past to verify they are responsible in having the pet spayed or neutered and have given their pets good overall care.
Home deliver the animal! A must to assure proper fencing and overall good, clean conditions for the animal.
Remember, these animals deserve a good loving home for the rest of their lives (up to 20 years).
Without doing proper background checks on potential new owners, you help to keep the vicious circle of overpopulation, abuse, neglect and disposal of many animals.
PLEASE, STOP THE CYCLE OF ABUSE.
SCREEN YOUR APPLICANTS!


Pet Adoption Questionnaire

Pet Information:

Name of Per:____________________________________________

Canine: Feline: Other: Breed: ____________________

Estimated Age:________ Spay/Neutered: Yes No

Vaccinations: Yes No Felines: Canines:
 Leukemia Distemper Rabies DHLP-Par
FVRCP Corona
FIP Bordatella
Deworm
Rabies

Applicant Information:

Name:______________________________________________________

Address: ____________________________________________________Home Phone:___________________

City: _________________________________State:_____ ZIP:_________Work Phone: ___________________

Driver’s License:_____________________State:____________ Car License:____________________________

1. Do you live in a House: Condo: Apartment: Other: (Please Speiciify)___________________

2. How long have you lived there? _________________

3. Do you rent? Yes No
If yes, do you have permission from your landlord to have a pet? Yes No
May we contact you landlord? Yes No Name: ______________________________________

Phone: ______________________________________

4. Are you aware that pets need regular vaccinations and may require routine veterinary care? Yes No

5. Are you willing to provide adequate veterinary care if this animal becomes sick or injured? Yes No

6. Name of veterinarian: ____________________________________________ Phone: _________________

7. Would you object to an inspection of your premises by our personnel? Yes No

8. Do you plan to put an I.D. tag on this pet? Yes No

9. Do you plan to spay/neuter this pet? Yes No
If not, please explain why ______________________________________________________________




10. How many hours per day will the pet be left alone? ____________________________

Where will the pet be kept during this time? ______________________________

Will the pet be kept: Indoors Outdoors Both

11. Is anyone in your home allergic to animals? Yes No Don’t Know

12. What other pets do you currently own? # of dogs:_______ # of cats:__________

# of others (please specify) __________

Please furnish breeds, sex and ages of all pets: ________________________________

________________________________

13. Please list the ages of children in the home. __________________

14. On the first night in the home, where will the pet stay? (please specify) __________________

15. Who will be responsible for the pet? ________________________________________________________

16. Have you ever owned a pet before? Yes No

If yes, what happened to the pet? _______________________________________________________

If deceased, please state cause if know, and how long ago? __________________________________

17. Pets have been know to chew/claw furniture, carpets and drapes and dig in the potted plants, etc. – how do

plan to deal with this problem? ____________________________________________________________

_____________________________________________________________________________________

18. If you are adopting a dog, are you planning to take it to an obedience class in your area? Yes No

19. How soon after the pet arrives in your home will it be left alone? __________________________________

20. How often do you travel? ______________________________

How will the pet be cared for when you are out of town? ______________________________________

21. What will happen to the pet if you move (locally)? _______________________________________________

Out of state? ________________________________________________________________________

Overseas? _________________________________________________________________________

22. Under what circumstances would you not keep the pet?

Divorce Move New Baby New Job Illness

Other (please explain) __________________________________________________________________

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Copyright © 1999 Animal Abuse Prevention Agency, Inc.



March 21, 2008