Name*

First Last

Occupation*

Spouse/Partner's Name

First Last

Spouse/Partner's Occupation

Primary Phone*

Cell Phone

Work Phone

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email Address*

Emergency Contact*

First Last

Emergency Contact Phone*

Name of Animal you are interested in adopting*

Have you ever been approved to adopt from us before?*

If yes, who and when?

Have you owned an other(s) before in your adult life?*

Who are you adopting this animal for?*

Are you 18 years or older?*

Are all members in the household in agreement about adopting an animal? (This includes any and all roomates)*

Type of dwelling*

Do you own or rent?*

If in a renting situation have you cleared the adoption of an animal with the owner?

Please provide proof witha letter or agreement

Accepted file types: pdf, jpg, png, Max. file size: 120 MB.

PDF format prefered

Where will the animal live?*

Do you have any other animals?*

What kind and how many animals?

Are all the animals you have spayed/neutered?

If no, why not?

Are all the animals up-to-date on their vaccinations

If not, why not?

Who is your veterinarian?

Which veterinary clinic is your vet at?

Do you regularly take your animals to the vet?

Do your other animals get along with animals?

Do you believe an animal should be declawed?

Are you aware that animals are nocturnal animals? (awake most the night)*

Where will you keep the cat while you are out of home?*

Where will you keep the animal at night?*

If you go on vacation what arrangements will you make for the animal?*

Describe a typical day for your animal:*

Describe your home environment. (calm and quiet / busy but relaxed / busy and chaotic)

Are there any children in the home?*

If yes, what are their ages?

Is anyone in your home known to be allergic to animals?

Are there any animal behaviour/traits you will not tolerate?*

Are you familiar with the needs of an animal?*

Please list a few:*

Have you had experience training animals?*

Describe the methods of training you like to use:*

How much do you think it will cost a month to feed an animal?*

How much do you think it will cost for vet care for the first 6 months?*

Have you ever had to retrieve an animal for running at large?*

Reason the animal went missing from the start?*

Would you be willing to have a representative of TBDHS visit your home PRIOR to adoption?*

Would you be willing to have a representative of TBDHS visit your home AFTER the adoption?*

Why do you want to adopt this animal?*

Why should this animal go to your family?*

Is there any reason why you would consider returning this animal?*

Please explain why:

References are required:

Landlord Name:

If renting, landlord reference required:

First Last

Landlord Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Landlord Phone:

Veterinary Clinic Reference

In submitting this form online, I authorize the TBDHS to receive information from my veterinarian regarding a reference for an adoption.

Veterinary Name:

First Last

Veterinary Phone:

Veterinarian Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Minimum of 2 local individuals who DO NOT reside with you

Individual 1 Name:*

First Last

Individual 1 Phone:*

Relationship to Individual 1:*

Individual 2 Name:*

First Last

Individual 2 Phone:*

Relationship to Individual 2:*

Individual 3 Name:

First Last

Individual 3 Phone:

Relationship to Individual 3:

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OTHER ADOPTION

ADOPTION

ADOPTION

References are required:

Veterinary Clinic Reference

Minimum of 2 local individuals who DO NOT reside with you

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