We are glad you've come to adopt a new pet from our organization. The following information is requested so that your adoption counselor can assist you in the selection of a new pet. The consultation process is designed to help us determine if the adoption is in the animal's best interest, and to assist you in finding an animal most compatible with your lifestyle. Completion of this form does not guarantee adoption of an HMF pet.
In order to be considered an adopter, you must:
• Be 21 years of age or older.
• Have identification showing your present address.
• Have the knowledge and consent of your landlord, if renting.
• Be able and willing to spend time and money necessary to provide appropriate training, medical treatment, and proper care for a pet.
Which animal are you interested in
Choose an animal:
Pawdry Hepburn/ Mouse
Skeeter- Fospice needed
What traits are you looking for in a pet
Are you over age of 21?*
How many people reside in your household*
What are the ages of the children in the home?*
Does anyone in the house have any known allergies to dogs or cats?*
Do you own or rent your home*
If you rent, please enter your landlord's name, phone number and full address.
How long have you lived at the current residence?*
Is your yard fenced*
Yard Partially Fenced
Yard Completely Fenced
What is the height of the fence
What type of fence
Do you plan to move in the next few years?*
Do you plan to find suitable housing that allows you to keep the pet?
Number of indoor dogs:*
Number of Outdoor Dogs*
Number of Outdoor Cats*
Number of Indoor Cats*
Please list any other pets.
Are all of your animals spayed and/or neutered?*
If no, why not?
Are the other pets on heartworm prevention?*
If no, why not?
If you have cats, are they tested for feline leukemia?
Have you owned a pet before?*
What happened to your last pet? (i.e., surrendered, died, gave away, etc.)*
Have you ever surrendered a pet?*
If so, please explain the circumstances/reasons.
How much time will the animal spend alone during the day*
Where will the animal be kept when you are not home? (i.e. crate, garage, house, etc.)?*
Where will he/she sleep?*
What do you estimate, as the cost of veterinary care and feeding, etc. for this pet for one year?*
Who will be in charge of caring for the pet?*
Why do you want this particular pet? (i.e., feel sorry for it, too cute to leave behind. companionship, teach kids responsibility, breeding, etc.)*
Please list your veterinarian's Name and Phone Number*
How long have you been associated with this doctor / hospital?
Please list an additional reference of a non-family member. Include their Name, Address, Phone Number and E-Mail Address.*
The Adoption Fees are as follows:
$300 puppies up to 6 months
$175 adult dogs
$100 mature/medical/special needs
$100 kittens up to 5 months
$50 adult cats
$35 mature/medical/special needs
This fee includes all current vaccinations, microchip, fecal, heartworm and feline leukemia/ immunodeficiency viral testing as appropriate, and the pet is spayed or neutered. The fee also includes two months worth of heartworm prevention. If the pet is too young for the spay/neuter surgery or completed vaccine series, it may still be released into your care but would need to be returned for completion of the vaccines or surgery.
We check references and a home visit is required to complete the adoption.
By signing below, you are indicating that the information provided in this application is accurate and true and agree to allow us to request a release of veterinary information on current and past pets and authorize the veterinarian or his/her representative to discuss the care you provide for your pets with a member of Hope Marie’s Fund rescue.
Enter your name and date:*