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Humane Society of the Lakes
Adoption Application
Adoption Application
Thank you for taking the time to fill out our questionnaire. The purpose of this application is to learn a little about your family and home so that our organization can make the best possible match for both you and our rescue animal. Our main concern is placing our animals in a compatible home with a family that will give them a LIFETIME commitment of love and proper care. This consultation process is designed to help us determine if the adoption is in the best interest of both the animal and the adopter. Please be aware that while completing this application does not bind you to adopt one of our animals, neither does it guarantee that we will place one of our animals in your home at this time. If you are interested in learning more about one of our rescue animals, please answer the questions honestly and thoroughly.

Some animals may need some extra time and patience to adjust to yet another new home. Some may need house training or other types of training, and some may just need a little extra love and patience. All animals, regardless of their background and history, go through an adjustment period when they go to a new environment. There will be a period of a few days, weeks or in some cases months during which your new pet's personality is emerging and growing while you get to know one another. Please remember that this is a stressful time for an animal and hopefully we will be able to work together to make this a lifetime relationship for you and your rescue pet. You can call on us at any time to help you in any way. With this is mind, please answer the questions on the application to the best of your ability.

We reserve the right to refuse adoption to anyone for any reason. A representative of our group may conduct home visits prior to or following an adoption, and our group has the right to reclaim an animal following an adoption if unsuitable home conditions, evidence of neglect, abuse or other mistreatment of the animal are found on this visit.

* Be 18 years of age or older.
* Have identification showing your present address.
* Have the knowledge and consent of your landlord.
* You must spay or neuter the adopted animal.
* Be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet for the entire life of that animal.

Name of others living/caring for animal in household (if any):
Address (including City and Zip-code):
Phone numbers:
Best way/time to contact you:
Place of Employment:
Emergency Contact (other than someone living in the home):
Address (including City and Zip-code):
Are all family members in agreement about adopting an animal?
    Yes   No  
Is there a specific animal you are interested in adopting from us?
    Yes   No  
If so, which animal and why?
Do you have children?
    Yes   No  
If yes, what are their ages?
Do you own or rent?
    Own   Rent  
If you rent, what is your landlord's name and telephone number?

Verification required landlord:

Date Received: __________________________

HSL Staff Initials: _______________________
Have you already received permission for the animal you would like to adopt?
    Yes   No  
How long have you lived at the property?
Are you planning to move anytime in the near future?
    Yes   No  
Have you owned an animal(s) at this residence in the past?
    Yes   No  
If yes, is the animal still at the residence?
    Yes   No  
If no, reason?
Your veterinarian's name, hospital/clinic, city, and phone number (if known):
Does anyone in your home have pet allergies?
    Yes   No  
Dog adoptions only:
You would like a dog for: house pet, guard dog, companion, gift, companion for another dog, or other (please explain):
How will your dog be confined to your property (please include all that apply)? In the house; in a crate or kennel; in a fenced yard; on a chain; in a garage; on a patio; other...
Cat adoptions only:
You would like a cat for: house pet, mouser, companion, gift, companion for other pet, other (please explain):
Will this cat be allowed outdoors?
    Yes   No  
Do you plan to have this cat declawed?
    Yes   No  
All adoptions:
Have you ever adopted an animal from HSL?
    Yes   No  
If yes, when?
Do you have any other pets now?
    Yes   No  
If yes, how many?
Are they indoor or outdoor pets?
Are they spayed/neutered?
    Yes   No  
If no, reason?
Are they current on vaccinations?
    Yes   No  
Onsite pet visit completed: Yes___ No___ N/A:___


Visit outcome:_________________________
Have you ever had to give up an animal before?
    Yes   No  
If yes, reason?
Do you have a yard?
    Yes   No  
If yes, is it fenced?
    Yes   No  
Where will your pet be kept during the day? And at night?
How many hours will this animal spend alone each day?
How long do you feel an animal should be given for an adjustment period?
Are you willing to work with a new pet on any issues he or she may have?
    Yes   No  
What behaviors would be unacceptable to you?
What actions would you take to correct these behaviors?
Excluding your death, what conditions or circumstances would cause you to give up an animal?
Are you prepared to provide for your animal's continued health care, including proper diet, annual examinations, vaccinations, and other treatment?
    Yes   No  
Do you understand the importance of getting your pet spayed or neutered and agree to do so if necessary according to the legally binding adoption contract?
    Yes   No  
Additional questions or comments:
Please read and understand the following conditions and initial accordingly.
*HSL does not guarantee that the adopted animals are housebroken, have no bad habits/behaviors, or are purebred

*HSL will not be responsible for any and all health problems with which the animal may have or had come into contact with.

*Adopter agrees to absolve the HSL and its employees, directors, and volunteers from any liability for present or future damage, injuries or any loss/cost caused by this animal.

*Adopter assumes ALL financial responsibility for the animal once the contract is signed by the Adopter.

*Adopter assumes FULL responsibility for the health, condition, and care (to include behaviors of any kind) of the animal once the contract is signed by the Adopter.

*HSL does not allow adoptions of any animals with known aggressive tendencies.

*All HSL animals have had a Temperament & Obedience Assessment prior to adoption.
Adopter's Initials:
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