Adoption Form

If you are interested in adopting a pet from Hope Animal Medical Center, please fill in the following information. Someone will follow up with you to talk further about your interest in the pet.

Please fill out the following information. The * denotes a required field.

* Indicates required field

Your name *

First

Last

Name or description of the animal you're interested in adopting *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Spouse / partner full name *

First

Last

Do you currently have a securely fenced in yard? *

Yard size is approximately how big? *

What type of home do you live in? *

Your home is in a... *

If you are renting, do you have your landlord's permission to own the type of animal (species and breed) of pet you are trying to adopt? *

Please provide your landlord's name and phone number *

Attention renters: Proof that the pet can live in your home must be provided before adoption. Please not that we reserve the right to contact your landlord/ apartment complex for verification.

Living Situation

Who will be primarily responsible for the financial responsibilities and daily care of the pet? *

Does every individual in the home agree to adopting the pet you are applying for? *

Are there any children under the age of 18 living in your home? If yes, what are their ages. *

Pet living situation (check all that apply) *

Pet will be a house pet, living inside with the family Pet will live in the basement or garage Pet will live outside Pet will live both indoors and outdoors Other

If you checked Other above, please explain. *

Have you ever had an outside only pet? *

If you said yes to the question above, please describe their living conditions. *

If applicable, how many hours per day will the pet be home alone? *

If applicable, when the dog is home alone, it will be... *

If you checked Other above, please explain. *

If applicable, how will you exercise your dog? *

If you checked Other above, please explain. *

Where will/do your pets stay when you go on vacation? *

If you checked Other above, please explain. *

Do you have any other pets? *

Other pets and experience

What are their names, species/breeds, ages, spayed/neutered? *

If you have had/ have pets that are not spayed or neutered, please explain why. *

If you've had other pets in the past, please let us know their current disposition: *

If applicable, please explain what happened to your pet. *

Please provide the name, address and phone number for your CURRENT and PAST veterinarian/clinic. *

For dogs only: Is/ were your dog(s) current on their vaccinations and heart worm prevention? *

If you selected No above, please explain why. *

Are you aware of the financial responsibility involved in owning a pet? This includes but is not limited to high quality food, toys, treats, annual vaccinations, flea and tick prevention, heartworm prevention, emergency care, etc. *

If yes, are you prepared to take care of this animal for the duration of it's life? *

Feel free to provide us with any additional information about yourself that you feel may be relevant. *

Please be advised that we do not do same day adoptions. Your application has to be approved before you can take the animal home. The adoption coordinator will call or email you if we have any questions about your application or if it has been approved. It can be anywhere from 2 - 7 days for us to process your application, especially if it's on the weekend. If you do not fill out the application correctly/fully this will only delay the process. Our applications are used as part of a screening process. We do not adopt animals on a first come, first serve basis. We choose the most appropriate home for each pet. Please be advised that filling out an application does not guarantee that you will be able to adopt the animal.

Signature

By typing your name below, you are signing this application, asserting that the information you provided above is 100% accurate and true.

Sign your name *

First

Last

Submit

1150 MITCHELL BRIDGE ROAD • ATHENS, GA 30606 • PHONE: 706-546-7879 • FAX: 706-546-1992