E-mail Address: *
Name:
Address:
City:
State:
Zip:
Tel No: Home:
Work:
Cell:
Drivers License Number:
Social Security No:
Date of Birth:
What kind of pet are you here to adopt? *
What are your reasons for adopting? *
If the pet is to be a gift, give the name of the person with whom the pet will reside:
Do you have any preference as to breed type, age, sex, size, or name of specific animal?
If yes, explain:
Have you ever had a pet before?
If so, what kind?
For how long?
How long ago?
Were your pets:
Was your pet spayed/neutered?
If that animal is no longer in your household, what happened?
Do you have pets in your household now?
If so, how many?
What kind?
What are their names?
Are they licensed?
Are they kept :
If you have cats, were your cats tested for FeLv (feline leukemia) and FIV?
Are you:
Spouse name:
Are there any children in your household?
If so, how many?
What are their ages?
How many adults in your household?
Do all adults know that you plan to adopt?
Are there any senior citizens or physically/mentally disabled persons in your household?
Do you live in a:
How long have you resided at your present address?
Do you:
Landlords name and phone #
Does anyone in your household have any known allergies to animals?
Is anyone home during the day?
If no, how long will the pet be left alone in a 24 hour period?
Where will your pet spend the majority of its time?
Are you financially prepared to give your new pet routine and emergency medical care such as rabies vaccinations, inoculations, exams, etc?
Have you ever adopted from us before?
Have you ever turned in an animal to us before?
Questions pertaining to dog adoptions only:
Will this dog be used for a:
Do you have a fenced in yard?
If yes, how high is the fence?
Does the fence drop in height at any points?
Do you have a:
Are the 2 yards separate from each other?
What kind of fence is it? (ex.: chain link, wood, etc.)
Are there holes in the fence?
Can an animal dig under the fence?
Are you familiar with crate training?
Are you familiar with leash and licensing laws in your community and will you have your new pet licensed immediately?
Do you realize that you will probably have to housetrain your new dog?
What will you do if your dog chews furniture or shows other signs of destructive behavior?
How will your dog be confined to your property?
Questions pertaining to cat adoptions only:
Do you want the cat for a:
Will the cat be allowed outdoors?
What will you do if your cat claws your furniture or shows other signs of destructive behavior?
Who is your veterinarian?
Phone #
Will you spay or neuter your pet within 30 days?
How did you hear about us?
Would you object to a visit from an FOS representative to see how you and your new pet are doing?
Thank you for taking the time to complete this questionnaire. Your answers will enable us to "match" a cat or dog to you and your household. Good luck!
NOTICE :
A. The FOS reserves the right to refuse adoption to anyone.
FOS has my permission to contact my veterinarian regarding my pets.
Date:
Signature:
* Required
