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