Pet Name
Artemisia (Cat - C2506056)
Belladonna (Cat - C2506057)
Bucket- Adoption Pending (Cat - C2506058)
Cinta (Cat - C2504014)
Daphne (Cat - C2503006)
Dusty (Cat - C2506054)
Florence (Cat - C2506065)
Jonathan (Cat - C2506061)
Joyce (Cat - C2506060)
Jumba (Cat - C2505040)
Junee (Cat - C2504017)
Lil Kim (Cat - C2506070)
Lilo (Cat - C2505041)
Mertle (Cat - C2505039)
Midnight (Cat - C2506055)
Penny (Cat - C2506059)
Phoenix (Cat - C2506071)
Reef (Cat - C2506063)
SZA (Cat - C2506068)
Stitch (Cat - C2505038)
Theo (Cat - C2506062)
Toby (Cat - C2506064)
Victoria (Cat - C2504012)
If pet not listed, please type it here
Individual or Couple *
Individual
Couple
Primary First Name *
Primary Last Name *
Primary Cell Phone *
Home Phone
Primary Email *
Confirm email
Secondary First Name *
Secondary Last Name *
Secondary Cell Phone *
Secondary Email
Street Address *
Use N. S. E. or W.
City *
State *
AR
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip *
Why do you want to adopt this pet?
Companion for you
Companion for other family member
Companion for other pet
Current Veterinarian's Name, Phone Number *
If you have never had a pet before please list the vet that you will likely use.
Name listed on vet records *
Previous Veterinarian's Name, Phone Number (if no current vet) *
Do you use low cost vet clinic, or vet listed *
List ages of everyone in household *
Primary Caretaker *
Family member allergies *
Is there anyone in the home who may be adversely affected by dogs/cats (allergies, etc.)?
No Yes
Do all members of household want to adopt this pet? *
No Yes
Do you own your home? *
If no, please provide landlord's name and phone number
Type of Residence *
House, Townhouse, Condo, Mobile Home, Other
How long at present residence? Do you plan on moving in the near future?
Please explain *
How do you rate your pet experience?
First Time Owner
Beginner
Intermediate
Advanced
Please list the pets in household now, age, breed, & sex: Are they vaccinated? Spayed/neutered?
List Pets *
Tell us about any pets you have owned in the past 10 years: What happened to these pets?
List past pets *
Will pet wear collar and ID tag *
No Yes
How will you handle behavioral issues *
Would you be willing to take the pet to obedience training?
How many hours a day will this pet spend without humans? *
When will the pet be inside? *
All the time, at night, In and Out, Never
Where will the pet sleep at night *
Which of the following behavioral issues would prompt you to give up your pet? Check all that apply:
Biting/Scratching Family Member
Not Friendly with Guests
Scratching Furniture or Carpet
Shedding
None
Which of the following reasons would prompt you to give up your pet? Check all that apply:
Moving
Having a baby
Allergies
Divorce
New Spouse/Partner doesn't Like Pet
Financial Problems
Pet's Health Problems
Excessive Veterinarian Bills
None
Would you agree to a home visit by an Out of the Woods representative? *
No Yes
If there is any other relevant information you would like us to know *
Initial Here *