ADOPTION AGREEMENT
NAME________________________________________________ PHONE_______________
ADDRESS____________________________________________________________________
DL#______________________RENT____ OWN____ HOW LONG?_____________
PERMISSION FROM LANDLORD OBTAINED IN WRITING? YES__ NO__ NA__
VETERINARIAN REFERENCE? YES__ NO__
HOME VISIT? YES__ NO__
NAME OF ANIMAL BEING ADOPTED:________________________________
HEALTH/VACCINATION RECORD PROVIDED? ___ IF NO, NAME & PHONE of
VETERINARIAN:______________________________________________________________
COMMENTS:__________________________________________________________________
______________________________________________________________________________
In the event the adoption does not work out at any time, I agree to return the adopted animal(s) to:
Name:_____________________________________ Email: __________________
Address:____________________________________________________________
Home Phone: ____________Work phone:_________
I agree to a home visit if requested. I agree to have the animal altered at six months of age or sooner if the animal is not already altered. I agree to have all vaccinations, preventive and medical care recommended by my veterinarian for this animal. I agree to keep an adopted cat inside and to have control of an adopted dog at all times. I understand that my failure to comply with these promises may require that I return the animal.
ADOPTER SIGNATURE:________________________________ DATE:_______
__ copy provided to adopter