Adoption Application-HH&S

Thank you for your interest in adopting from Hoppy, Healthy & Safe!

Please complete all questions- incomplete applications will not be processed.

Type of Animal You Are Interested in Adopting *
Name of Specific Animal You are Interested in Adopting
First Name: *
Last Name *
E-Mail Address *
Address *
Phone Number *
Date of Birth * Please Note we cannot accept applications from anyone under 18
Do you rent or own your home? *
If other please explain
If you rent, what is the name and phone number of your landlord?
If you rent does your landlord and lease allow you to have this animal?
List the names and ages of each member of the household *
Is everyone in the household in agreement about adopting this animal? *
Does anyone in the home smoke? *
Who is going to be spending the most time with your new pet? *
Please tell us why you want to adopt this animal *
Does anyone in the household have allergies to any animals or hay/grass *
Please tell us what kind of experience you have with the type of animal you are wanting to adopt *
Please describe your enclosure *
Please describe what you plan on feeding your new pet *
Please provide the name and number of the veterinary clinic you will use to provide care for this pet. * If you do not have one, let us know and we will be happy to provide you with information for exotic vets in your area!
List your current pets and the last time they were seen by a vet and why. *
Have you ever had to surrender/sell/rehome a pet? *
If yes, please describe the reason
Please describe what circumstances you would consider surrendering or returning an animal *
Have you( or anyone in your house) bred animals before (either on purpose or accident?) *

Reference # 1 *
Reference # 2 *
*	HH&S reserves the right to accept or decline adopters based on the information gathered. For reasons of confidentiality HH&S will not share this information or reasons for denial.
By signing below I certify that the information I have supplied is correct to the best of my knowledge. I give my permission to contact the references and veterinary clinic listed. *