Adoption Application-HSA

This application has no guarantee of adoption. In order to adopt, you must visit our shelter.

Animal you are interested in adopting *
Are you 18 years old or older
Applicant's First Name *
Applicant's Last Name *
Street Address or PO Box *
City *
State *
Zip Code *
Email Address * Please enter correctly as this is the main way we will contact you
Confirm email
Cell Phone Number *
How did you find out about us? *
Is this pet for you or someone else? *
Do you own other pets at the current time? *
Please list their names, breeds, and ages. *
Are all of your pets spayed/neutered/fixed?
Are your pets current on their vaccinations? *
Have you ever turned your dog or cat into a shelter? *
If yes, please explain? *
Please check the main reason you plan to adopt a pet: *
If you answered "other" above, please explain here: *
Please describe in detail the pet you are looking for. *
Do you own or rent your home? *
Please select your current residence type. *
If you answered "other" above, please explain here: *
How long have you lived at this address? *
If you rent, does your landlord and lease allow pets?
Including yourself, how many people live in your household? *
Is everyone in your household aware that you are planning to adopt a pet? *
On average, how many hours per day will your pet be left alone? *
Will this pet be predominantly living inside, outside, or both?
Do you have a completely fenced-in yard? If so, what kind of fence? *
How will you handle housebreaking? *
Are you willing and able to exercise the dog on a regular basis? *
What arrangements will you make for the care of your pets in case of an emergency? *
If you answered "other" above, please explain: *
Are you willing to take responsibility for this animal for the next 10-20 years? *
If no, please explain: *
By signing, I acknowledge that I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal. *