Online Adoption Form

Do you want to adopt a dog or a cat?

Dogs name that you would like to adopt:

Cats name that you would like to adopt:

ABOUT YOU

Your name (required):

Spouse/roommate name:

Address (include city, state and zip (required):

County:

Home phone (required):

Cell phone:

Your email (required):

Do you live in an:

Do you own or rent?  Own Rent

If you Rent:

Landlords name:

Landlords phone number:

How long at current address:

Do you anticipate moving?

Have you ever adopted from us in the past?

If yes when?

Is the pet going to be living with you?

If no where will the pet reside?

Are you prepared to meet the financial responsibility of owning a pet? (A cost of $300 to $500 per pet, per year)

Have you had other pets in the last 5 years?

If yes where are they now?

Do you have any pets at your residence?
(If yes, please list their breed, sex, age, and if they been spayed or neutered.)

How many people live in your household?

Do the adults in the household know you plan to adopt?

Do you have children?

What are their ages?

Do any of your family members have allergies to any animal?

Who is your veterinarian?

Veterinarian's phone number:

Dog specific adoption questions (Do not answer for cat adoptions)

Why do you want a dog?

What attributes are important to you in a dog?

Size:

Temperament?

Breed?

Hair/Coat:

Please tell us the characteristics you would like in a dog (hold down the CTRL key to select multiple characteristics):

Of these characteristics please tell us the ones that are critical to you (hold down the CTRL key to select multiple characteristics):

What is your lifestyle?

How many hours a day will the dog be without adult care?

Do you have a fenced yard? Fence Height?

If no please tell us how you intend to exercise and potty the dog.

Where will the pet sleep?

How much time will the dog spend:
outdoors? Indoors?

If the dog will be outdoors, is their shelter or a doghouse available?

Cat specific adoption questions (do not answer for dog adoptions)

Is this your first experience with a cat?

You want to adopt this cat for (hold down the CTRL key to select multiple options):

Will the adopted cat live?

Who will be responsible for the care of this cat?

By submitting this application I
understand that I may not declaw any cat I adopt from Home at Last, at any time. Doing so will result in the breaking of the adoption contract, and Home at Last may take any appropriate action for the welfare of the animal as noted in the adoption contract. I understand that this potentially debilitating procedure may lead to behavior problems. If I have any problems with my cat scratching, I will turn to Home at Last and my Veterinarian for assistance to resolve the problem effectively and humanely, without resorting to surgical declawing or a tendonectomy.

I am aware that Home at Last has examined this cat, provided preventive medical care, and disclosed in writing all known medical issues. I understand that all animals can carry and transmit disease, some of which may affect other animals and/or people and that these diseases may be undetectable in what appears to be a healthy cat at the time of adoption. I understand that my new cat may have been exposed to contagious diseases such as ringworm and feline upper respiratory infection, and that these conditions are usually highly treatable. I accept this cat as AS IS at the time of adoption, taking responsibility for the cat’s care and well-being, including all medical care which may be necessary after the time the cat is released into my care. I understand that Home at Last is not responsible for any medical conditions not detected prior to the time of
this adoption. I understand that I should keep my new cat isolated from other pets for a minimum of seven (7) days.

Thank you for taking the time to answer our questions. We hope that by going through this process, we will reduce the chance of an inappropriate match both for you and for our animals. If you have any comments regarding this adoption application or our adoption process, please feel free to let us know as we are always looking for ways to improve! Again, thank you for considering a rescue pet and saving a life.

How did you hear about us?