Animal Adoption Questionnaire



Pet Paw-see

Matchmaking Form – Cats

Please return to: PO Box 6491, Great Falls, MT 59406

Email: leslie10@

Date: ______________ Animal’s Name:_____________________

Personal Information:

Name: _______________________________________________________ Home Phone: ________________________________

Address: _____________________________________________________ Email Address:_______________________________

City: ________________________________ State: _____ Zip Code: ___________ How Long at this Address: _______________

If less than 2 years, please list your previous address: _____________________________________________________________

Marital Status: Married / Divorced / Single - Children in the home: Yes / No – If yes, how many? _____ & their ages: _________

If you have children, do they understand how to care for a cat, and how to treat them humanely? Yes / No

Name of Employer: _______________________________________________________ Phone: ___________________________

Name of Spouse’s Employer: _______________________________________________ Phone: ___________________________

Does anyone in your family suffer from pet allergies? Yes / No Have you adopted from an animal shelter before? Yes / No

Residential Information:

Residence: House: _____ Apartment: _____ Condo: _____ Mobile Home: _____ Live with Parents: _____

If Renting, Landlord’s Name: _______________________________________________ Phone: ___________________________

Besides your immediate family, are there others residing in your home? Yes / No – If yes, who? ___________________________

Are all adults living in the household in favor of this new pet? Yes / No

Do you have a “Doggie Door?” Yes / No – If yes, can it be blocked off so your cat cannot escape? Yes / No

What do you plan to do with your pet if you move, or are forced to move? ____________________________________________

Adoption Information:

Have you ever owned a cat? Yes / No – If yes, how many (estimate if many): ____________

Will your cat be: Indoor/Outdoor: Outdoor Only: Indoor Only:____

Why do you want this particular cat, or what drew you to it? ________________________________________________________

What will you do with your cat if you move? _____________________________________________________________________

How much do you expect to spend on your new cat in a year for regular medical care (not including major surgeries)? _________

What will you do if your new pet scratches furniture or drapes, dumps trash, or is otherwise full of mischief?

_________________________________________________________________________________________________________

Are you considering having your new cat declawed? Yes / No

Please check all of the following that will apply to your new cat:

Mouser: _____ Companion: _____ Barn Cat: _____ Family Pet: _____

Other Pet Information:

Are all adult members of your household in favor of adopting a cat? Yes / No / Don’t Know

Do you have other pets? Yes / No - If yes, what kind and how many? ________________________________________________

Are they spayed or neutered? Yes / No – If no, why not (please explain)? _____________________________________________

Are your other pets current on their vaccinations? Yes / No – If no, please explain: ______________________________________

What will you do if your newly adopted pet does not get along with your other pets for a while? ___________________________

Do any of your pets have an infectious disease now, or have they in the recent past? Yes / No – If yes, please explain:

_________________________________________________________________________________________________________

How often, on average, do your pets need to visit their vet? ________________________________________________________

Have any of your pets had to have major surgery? Yes / No – If yes, please explain: ____________________________________

_________________________________________________________________________________________________________

References:

Veterinarian’s Name: __________________________________________________ Phone: _______________________________

Character References: 1. ___________________________________________________ Phone: _________________________

2. ___________________________________________________ Phone: _________________________

Please initial that you have read each of the following:

_____ I certify that the information provided on this form is true and correct.

_____ I am financially able to care for this animal.

_____ I understand that proper food and veterinary care will be costly and am able to meet these requirements.

_____ I understand that in some cases, a home check may be conducted prior to my adoption approval.

_____ I understand that any false statements constitute grounds for confiscation and surrender of the animal to a

representative of the Pet Paw-see.

_____ I further understand and agree that the Pet Paw-see may demand return of the animal for any violation of the terms

of this adoption agreement.

_____ If this animal does not work out in my home, I will call the Pet Paw-see for help. If this adoption does not work out,

for whatever reason, I will relinquish this animal back to the Pet Paw-see for further adoption proceedings.

_____ I WILL NOT take this animal to the Animal Shelter if the adoption does not work out.

_____ The Pet Paw-see accepts no responsibility for any liability or for any injury or damages to any person or property

caused by this cat, as well as any cause of action, claims, suits or demands whatsoever that may arise as a result

of such injury or damage.

** PLEASE REMEMBER TO ADOPT RESPONSIBLY! IF YOU HAVE ANY DOUBTS

WHEN SIGNING THIS FORM THAT YOUR NEW PET MAY NOT BE WITH YOU FOR ITS REMAINING DAYS,

PLEASE… SLEEP ON YOUR DECISION, FOR THEIR SAKE!!

CONSIDER WHAT THESE ANIMALS HAVE ALREADY BEEN THROUGH,

AND MAKE SURE THEY ONLY RECEIVE LOVE AND AFFECTION FROM HERE ON OUT. **

My signature below acknowledges that I have read and understood this form.

I will accept the above-described cat as part of my family and will care for it throughout its remaining days.

Signature: ________________________________________________________________ Date: _________________________

** The Pet Paw-see reserves the right to refuse any adoption **

Adoption Policy

Pet Paw-see, Inc. A non-profit animal welfare foster program

The Pet Paw-see’s (hereafter PPS) goal is to place companion animals in safe, loving, lifetime homes. To meet these goals, we must have basic requirements to help alleviate pet over-population and ensure responsible, caring pet ownership. 

1. Animals must be adopted primarily as household companion animals. No dog will be placed as a guard or attack dog, and no cat as

mouser only. 

2. Only healthy animals that show no aggressive tendencies or other serious behavior problems will be placed. 

3. As of 10-01-97, Montana State Law requires all canines and felines adopted from a shelter or pound to be altered. This requires that all

dogs/cats must be spayed or neutered by a licensed veterinarian within the time limits specified in our legal contract signed by the

adopter. All juveniles in the program will be sterilized prior to leaving with a new owner. Those too young will be required to be

spayed/neutered when old enough; females, 4 months old, males 6-8 months old. You may not adopt an animal too young to alter if

you have an unaltered pet of the same species at home.

4. No pet shall be given away to another home after adoption. If adopters’ circumstances change, the pet must be returned to PPS. 

5. No puppies or kitten under 8 weeks of age will be adopted. Puppies and kittens will not be placed in a home with children under 6 years. 

6. All adopters must be 18 years or older. Identification will be required. 

7. If an adopter resides in a rental unit, we must have landlord’s name and phone number and his/her approval to a pet living on the premises. 

8. Animals cannot be adopted as gifts. Animals shall not be given away or sold to another individual. They must be returned to PPS if the

adopter can no longer keep and care for the animal properly. Gift certificates are available to purchase for someone wanting to adopt a pet. 

9. The adopter must agree to provide the pet with proper care at all times: nutritious food, fresh water, weather-tight shelter when outside,

regular exercise and veterinary care, including shots and care to relieve suffering. 

10. We encourage all family members to be present at the time of adoption. All household members must want this pet. 

11. No animal can be adopted strictly as an outdoor pet. Animals need human companionship and must be made part of the family’s life. 

12. Continuous outdoor confinement on a chain or in a small enclosure is not acceptable. If you cannot confine a dog in a fenced yard,

then a cable run system is required. The cable run should be positioned so that the dog has access to food, water, and shelter that is

appropriate for ALL weather conditions. A fenced yard is ideal for all dogs. This protects the dog from roaming and owners from the

liability their loose animals may cause. Chaining, except for brief periods, is not acceptable. Dogs will not be placed in homes where they will be allowed to run at large. 

13. Animals will shed. They even wet on rugs, vomit, chew things, and dig in yards. Cats jump up on tables and counters and sometimes scratch furniture. If you cannot tolerate accidents, and you don’t have time to train this pet, then please reconsider this adoption. 

14. Declawing is discouraged. Declawing is the painful amputation of the first knuckle of the cat’s toe and is an inhumane practice.

It leaves your cat defenseless in an outdoor environment. Declawing is illegal in many countries.

15. Your companion cat may live 15-20 years. Your companion dog may live 10-15 years. If you are unable to give this animal a lifetime

home, DO NOT ADOPT IT!! 

16. PPS has the right to repossess any animal if there is evidence that the adopter has violated any of these policies. 

17. We ask that you allow at least 3 weeks for your new companion to adjust to you and its new home. 

18. Any person who agrees to these adoption policies may adopt from the PPS. The PPS has the right to refuse adoption to any person,

for any reason, at any time. 

I HAVE READ, UNDERSTAND, AND AGREE TO THESE ADOPTION POLICIES OF THE PET PAW-SEE, INC. 

Signature ____________________________________ Date______________________ 

Pet Paw-See Member Initials __________ Date ______________________ 

Top of Form

Bottom of Form

FOR PET PAW-SEE USE ONLY:

APPROVED: YES / NO COMMENTS: _______________________________________________________________________

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download