Adoption Questionaire

Thank you for choosing adoption! The following information is requested so that your adoption counselor can assist you in the selection of a new pet. In order to be considered as an adopter today you must be 19 years of age or older and have identification showing your present address. Please complete the following questions to help guide our conversation to abopt.

Animals Name Animal ID #

First Name Last Name Address City State Zip Code Email Phone Work Phone

Where do you currently Live? Ownership Type

How long are you away from home on an average day? How many adults in the home? How many children in the home? Ages of the Children? Do all adults know that you plan to adopt a pet? Our pet will live

Do you currently have other pets

Pet Name	Breed	Age	Sayed/Neutered	Declawed

We’ll explain this new pet’s medical history and behavioral history. Other Questions