Pet Application Form Please complete our application form below: Application InformationInformation on the pet(s) you are interested in.This application is for a *CatDogWhat type of pet are you looking for?I am interested in applying for *Single PetMultiple Pets (to adopt)Multiple Pets (to consider)Adoption inquiry is forFirst Pet Name *Second Pet NameThird Pet NamePersonal InformationContact information for person applying for pet.First Name *Last NameStreet Address *Apartment, suite, etcCity *Province *Postal CodePrimary Phone *Primary phone number for us to contact youSecondary PhoneSecondary phone number if we have trouble reaching youEmail Address *Main Email addressAlternate Email AddressAlternate Email in case we cannot reach youPersonal DetailsPersonal pet and household information to assist us with your adoption request.How many adults will share the home with your new pet? *12345Do You Have Children? *Yes (Living with)Not Living With But VisitNoCheck what applies to youWhat are the ages of the chilren sharing the home? *Please enter ages of children living and/or visiting with you.AlergiesWe need to understand if there are alergies to considerDo ANY of the children or adults have allergies or illnesses not conducive to pet ownership *YesNoPlease indicate if ANY person(s) have allergiesPlease specify *If so, and you currently have pets, how do you manage / monitor these setbacks with pets in your home? *Adoption History DetailsDetails related to past adoptions and pet care.Have you adopted a pet in the past? *YesNoAre you familiar with settling in a new addition to your home? *YesNoAre you willing to deal with temporary behavioural issues during an adjustment period? *YesNoHave you ever consulted your vet for assistance with behavioral issues? *YesNoHave you ever been required to give up or re-home a pet due to behavioral issues? *YesNoPlease provide detailsHave you ever been required to 'Put to Sleep' a previous pet due to costly medical care? *YesNoWhat were those circumstances?Current Adoption DetailsDetails related to care of the pet you are applying for.Do you plan to declaw a new pet introduced to your home and family? *YesNoUnsureHow much money are you willing to spend on yearly vet care? *including vaccines and check-ups, and parasite control as neededHow much money are you willing to spend on unexpected or emergency care? *that may be required for your newly adopted family memberHow much time will your newly adopted pet spend alone? *How many hours per day or weekDo you have a lifestyle / job that takes you away from home frequently? *YesNoWhat plan of care do you arrange for your pet during your times away from home? *Pet HistoryInformation on the pets you have owned and are currently in the home.What companion animals have you previously owned? *CatDogBirdHampster/Rat/Guinea PigReptileNoneAre they still a part of your family? *YesNoIf not, what caused you to part with them? *If your pet(s) is deceased, what were the circumstances? *Pets CurrentInformation on the pets you have currently in the home.What companion animals do you currently own? *CatDogBirdHampster/Rat/Guinea PigReptileNoneHow many "cats" are currently living in the home *Pick from dropdown123456789> 9Number of cats that will be introduced to the new petAges of all Cats *Are any of them Declawed? *YesNoAre the cats currently Indoor or outdoor cats? *IndoorOutdoorBoth in and outDo any of your cats have any known illnesses or parasite? *(Feluk/FIV, Distemper, Parvo, Mange, Ringworm, etc)DogsInformation on the dogs you have currently in the home.How many "dogs" are currently living in the home *Pick from dropdown123456789>9Number of dogs that will be introduced to the new petAges of all Dogs *Are the dogs currently Indoor or outdoor dogs? *IndoorOutdoorBoth in and outDo any of your dogs have any known illnesses or parasite? *(Feluk/FIV, Distemper, Parvo, Mange, Ringworm, etc)Other PetsInformation on the other pets you have currently in the home.How many "Hampster/Rat/Guinea Pig" are currently living in the home *Pick from dropdown123456789> 9Number of small pets that will be introduced to the new petHow many "Reptiles" are currently living in the home *Pick from dropdown123456789> 9Number of reptiles that will be introduced to the new petAges of all other pets *Vetrinary DetailsDetails of your current and/or future vet that will care for your adopted pet.Vet where your previous/current pets receive medical care:Are the pets in your home up to date with vaccinations and spay/neuter? *YesNoDo you have up -to - date vet records? *YesNo(Vaccs, Spay/Neuter certificate, Microchip)Please provide the name of the vet you will be using to care for a newly adopted pet:Vet StreetVet CityVet State/ProvinceVet ZIP / Postal CodeVet PhonePlease include the vetrinarian phone number if knownDo you have your pets registered for Pet Insurance? *YesNoWhat is the name of your Pet Insurance provider?You agree to a vet reference check by the rescue? *YesNoSend Application
