Adoption Questionaire

This pre-adoption questionaire will assist us in streamlining the adoption of your new family member! Please keep in mind that the completion of this application does not guarantee that the animal you are interested is available, as we do not hold animals and they are adoptable on a first come first served basis.

First Name *
Last Name *
ID Number * Include Type, State and number, for example "NCDL123456"
Street Address * Your CURRENT mailing address.
City *
State *
Zipcode *
E-Mail Address *
Confirm email
Phone Number *
Name of Pet you are looking to adopt If you are unsure of what animal you are interested in, that's ok! Leave this blank, the application still will assist us in helping you find a good fit.
Have you adopted from us before? *
Have you ever relinquished a pet to us? *
Please Explain *
Is everyone in your household aware of this adoption? *
We will be speaking to all adult residents to confirm everyone is aware of this application process and wants to have a pet added to the family. Please do not submit this application if you are "trying to talk someone into" adopting this pet or think "once they meet the pet, they will want one" or "I'm getting this pet as a surprise birthday present for them." In those scenarios, you are welcome to email us to discuss the pet, but we would like all adults in the home to be involved in the adoption process.
Who lives in your household? * Please note if there are any small children, as some animals may not be good with kids.
Do you own or rent your home? *
Has your landlord approved this adoption? * Please be sure to ask your landlord if there are any breed restrictions.
Do you currently have any other pets? *
Please list your current animals. * Include species and age
Are your animals up to date on all of their vaccines? * Cats and dogs need an FVRCP or DAPP booster yearly, and are legally required to be current on their rabies vaccine.
Please Explain *
Are all of your pets Spayed or Neutered? *
Please Explain *
Who is your current vet? *
Do you have a yard? *
Will this animal be living primarily indoors or outdoors? *
What kind of shelter will be available when/if they are outside? *
Where will the animal be sleeping? *
If you are adopting a cat, do you agree to keep them contained indoors for at least the first two weeks? * Cats need time to acclimate to their new environment. Keeping your cat indoors allows them to understand where their home is.
How many hours a day will this pet be alone? Please Explain *
Additional Comments? Any additional comments, questions or concerns? Anything else you would like us to know to help match you up to a pet?
I understand that completing this application does not guarantee I will be allowed to adopt a dog or cat, and that the application is a tool to help the Yancey County Humane Society determine if this dog and/or cat and my family are a good fit for each other. I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved. I also certify that I have never been convicted of animal cruelty or neglect. I agree to allow a representative from the Yancey County Humane Society to contact my vet for a reference. If I am approved to adopt a pet, I agree to pay an adoption fee and hand sign an adoption contract at the time of adoption. I understand that all pets adopted from the Yancey County Humane Society will be spayed/neutered, vaccinated, and microchipped prior to adoption.
*	I/We have read and understand all of the above.