| Do you live in a house or an
apartment? |
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| Do you own or rent your home? |
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| If you rent, please list the name and
phone number of your landlord: |
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| How many adults are in your
household? Are they aware you are adopting? |
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| Are there any children in your home?
If yes How many? |
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| Please list each child's name and
age: |
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| Does anyone have allergies to cats
and/or dogs? |
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| Please list the current animals in
your house: List their ages and type |
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| Have you ever given up a pet before?
If yes, please describe why. |
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| Please provide us with your current
veterinarian's name and address: |
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| Will your pet be an indoor only pet?
If no, please explain: |
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| If adopting a dog: |
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| Please list how many hours it will be
alone: |
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| Do you have a fenced in yard: |
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| Will you enroll your dog in obedience
training? |
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| How will you exercise your dog? |
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| Are you aware that any dog you may
adopt may bark, dig, mount people's legs, and have accidents in the
home? |
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| If adopting a cat: |
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| Do you plan on de-clawing your cat?
If yes, please explain why. |
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please understand that we do not
usually adopt out cats that will be eventually declawed. |
| If your cat is clawing at furniture
or being destructive in other ways such as inappropriate marking, do
you plan on working with your cat to alleviate this problem? |
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| We require that all pets be spayed or
neutered. Do you have any questions or reservations about that? |
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| Are you aware that it usually costs
between $250 and $750 per year to feed, house, train and provide
veterinary care for a pet? |
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| Are you aware that any animal you
adopt from us will be a companion animal only? That you will not
sell, give away or use this animal for experimental purposes, allow
it to engage in dog fighting or train it to be an attack/guard dog? |
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| Please read our adoption mission and agreement: |
To
provide proper and adequate food, water, housing, exercise, grooming
and humane treatment at all times. To provide veterinary care such
as annual vaccinations, preventative heartworm medications as
appropriate, and such veterinary medical care as is necessary to
prevent and/or treat accidents and illnesses. To obey local
licensing and animal confinement laws.
If not performed already, to agree to having it
spayed/neutered before taking home. If the pet is too young to be
spayed/neutered, you will have 2 months from adopting pet to
schedule.
That you have been informed that all animals can
from time to time, carry and transmit diseases, some of which effect
people, including bacteria, viruses, parasites, and fungal diseases
and that these diseases may be undetectable in what appears to be a
healthy animal at the time of adoption. That Newtown Veterinary
Hospital is not responsible for any medical conditions not readily
detected or detectable prior to or at the time of this adoption or
discovered after such adoption.
If you are unable to keep this animal for any
reason, that you agree to return he/she back to Newtown Veterinary
Hospital to assess. |
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| I acknowledge that I have read this
agreement and hereby release Newtown Veterinary Hospital from any
present or future liability associated with my adoption of this
animal. |
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| I agree to adopt the above mentioned
animal as of
(date) |
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| Sign here if you agree to our terms: |
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| The cost of adopting an animal is $75
and includes a full medical exam, vaccinations, deworming, microchip
placement, any initial medical attention necessary and
spaying/neutering. |
