Hands to Paws Adoption Application

What species are you looking to adopt? *

Is there a specific animal in our rescue you are looking to adopt? *

Animal you are interested in adopting

Please describe in detail the type of pet you are looking for. *

Applicant's First Name *

Applicant's Last Name *

Street Address *

Apartment Number (if applicable)

City *

State *

Zip Code *

Home Phone Number

Cell Phone Number

Email Address *

Date of Birth *

Driver's License Number

Driver's License State

How did you find out about us?

Have you applied anywhere else for a pet?

Where else have you applied for a pet?

Is this pet for you or someone else? *

Reason for applying on behalf of someone else *

Do you own other pets at the current time? *

Are your pets current on their vaccinations? *

List their names, breeds, and ages. *

Are all of your pets spayed/neutered/fixed? *

Why are your other pets not altered?

How many pets have you owned in the last 5-10 years? *

What happened to them? Select as many as needed. *

Provide an explanation if you selected that the animal died, was lost, was given away, or other. *

Were any of your pets obedience trained?

Veterinarian's Name *

Veterinarian's Address, City, State, and Zip Code

Veterinarian's Phone Number

Have you ever had a pet euthanized? *

Please explain: *

Have you ever declawed a cat? *

Pets should be spayed / neutered. *

Do you plan on declawing your new cat(s)? *

Are you familiar with heartworm and heartworm prevention?

How will your current pets adjust to a new pet in the house?

Please check the main reason you plan to adopt a pet: *

Explain why you chose "Other".

Do you own or rent your home? *

Does your landlord and lease allow pets? *

Please select your current residence type. *

Explain why you chose "Other". *

How long have you lived at this address? *

Including yourself, how many people live in your household? *

List the ages & relationship of those who live in your home. *

Is everyone in your household aware that you are planning to adopt a pet? *

Does anyone in your household have allergies to dogs/cats or asthma? *

Please explain the allergies or asthma. *

Employment Status *

If you chose "Other" for Employment, explain.

What is your current occupation? *

On average, how many hours per day will your pet be left alone? *

How much do you think the annual medical bills will be for your pet? *

What would you do if the bills went over this amount? *

Will this pet be predominantly living inside, outside, or both? *

Please provide a description of your new pet's living conditions. *

What type of fence do you have? *

Explain why you chose "Other".

If you do not have a fenced yard, how will you let the animal out? *

Are there times when the animal will be tied/chained up? *

When will they be tied/chained up?

Where will the animal sleep? *

Explain why you chose "Other". *

Will the animal spend any time in a garage? *

When would the animal be in a garage? *

Do you have a pool? *

Is there a fence around the pool? *

What kind of fence do you have around your pool? *

Explain why you chose "Other". *

How will you handle housebreaking?

How will you handle destructive behavior?

Will you keep the animal up-to-date on vaccinations (cats and dogs) and heartworm preventative (dogs)? *

Explain why you chose "No". *

Are you willing and able to exercise the dog on a regular basis? *

What is the method of exercise?

Explain why you chose "Other".

Have you ever been convicted of abuse or neglect of a child or animal? *

Explain: *

Do you drive a truck? *

Would you allow the animal to ride in the back/bed? *

What arrangements will you make for the care of your pets in case of an emergency? *

Explain why you chose "Other". *

What will you do with the animal when you go on vacation? *

Explain why you chose "Other". *

For what reason(s) would you consider returning/giving up the animal? *

What would you do with your animal if you had to move? *

Explain why you chose "Other". *

Are you willing to take responsibility for this animal for the next 10-20 years? *

Explain why you chose "No". *

Will you allow us to perform home checks? *

Are you or anyone in your house military? *

Are you subject to transfer or deployment? *

Explain what would happen to your new pet if you were transferred or deployed. *

Provide two non-family references *

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. I am also aware that we cannot guarantee the health and temperament of the animal. *