Adoption Application - Helping Hands for Little Paws

Helping Hands for Little Paws Adoption Application
Please remember adoption is a privilege and we reserve the right to deny any adoption application.
Incomplete applications will NOT be considered.

Pet Being Applied For: *

Name *

First

Last

Spouse's Name *

First

Last

Street Address *

City *

State *

Zip Code *

Date of Birth *

How long have you lived at your address? *

Email *

Home Phone Number *

Cell Phone Number *

Work Phone Number *

Place of Employment *

How long? *

Do you live in a *

House Apartment/Condo Mobile Home

Do you live with relatives? *

Yes No

Do you *

Rent Own

Approximate square footage of home *

Landlord's Name & Phone Number *

Does your landlord require a deposit? If yes, have you paid it? *

Yes; I have paid the deposit Yes, but I have not paid the deposit yet No deposit is required

Do you have a fenced in yard? *

Yes No Partially

If your yard is partially fenced, please describe. *

Area fenced in? How tall is the fence? *

What type of fence? *

Number of adults in home *

Number of adults home during the day *

Number of children in home *

Sex & Ages of children *

Please describe your lifestyle *

Current Pets - Please check all that apply *

Dogs Cats Other (Ferret, Guinea Pig, etc.) No Other Pets

If you own dogs, how many? What are their breed? *

If you own cats, how many? *

If you have other pets, are they spayed or neutered? *

Yes No

Are you pets current on vaccinations? *

Yes No

Are you present pets on Heartworm prevention? If so, what kind? *

Where do your present pets sleep? *

Are other cats in the home declawed? *

Where do your present pets spend the majority of their time when you are NOT home? *

Where do your present pets spend the majority of their time when you are home? *

Method of Training Correction used? (example: crate training, obedience training, positive reinforcement, type of collar, etc.) *

Have you had other pets in the past 5 years? *

Yes No

Do you still own these pets? *

Yes No

If not, why? *

Have you ever adopted a pet before? If so, from whom? *

Where will pet being applied for spend the majority of its time? *

Where will pet being applied for sleep? *

If adopting a cat: Are you planning to declaw? Please explain. *

If adopting a dog: Have you ever housetrained before? If so, what method did you use? *

Why do you wish to adopt this animal? (Please check all that apply) *

If adopting as a gift, who is it for and what is their relationship to you? *

Where will the pet being applied for spend most of it's time when you are at home? *

Where will the pet being applied for spend most of it's time when you away from home? *

Name of current veterinarian and clinic *

Veterinarian's Phone Number *

By applying for the adoption of an animal from Helping Hands for Little Paws, you hereby give your veterinarian (s) and other references permission to disclose information to Helping Hands for Little Paws. To aid in this process, please contact your vet to let them know that we will be contacting them. *

Yes No

Standard medical care costs from $150-$300 per year. Emergency care can cost hundreds, even thousands, of dollars. Are you willing to provide standard and emergency care for this pet? *

Yes No

Post-Adoption Requirements: 1) You must take the animal to a veterinarian within 7 days of the adoption for a check up. 2) You are required to sterilize if the pet is not already sterilized by date on the contract. 3) You must return the animal to us if you decide you can no longer keep it. You cannot transfer ownership, sell the animal or give it away to someone else without the consent of Helping Hands for Little Paws. 4) You are responsible for providing appropriate shelter, nutritional food, water, exercise, medical care and humane treatment at all times. *

Yes No

Helping Hands for Little Paws tries to ensure that all animals we adopt are healthy. If you take an animal home and it becomes sick, we will gladly tak the animal back. However, we will not be responsible for any veterinary bills incurred in the interim. Do you agree to this provision? *

Yes No

I am 21 years of age or older. *

Yes No

By typing my name in the box below, I certify that the information given on this Adoption Application is true and correct. *

Helping Hands for Little Paws

Helping Hands for Little Paws Adoption ApplicationPlease remember adoption is a privilege and we reserve the right to deny any adoption application.Incomplete applications will NOT be considered.

Helping Hands for Little Paws Adoption Application
Please remember adoption is a privilege and we reserve the right to deny any adoption application.
Incomplete applications will NOT be considered.