cat adoption application - Animal Rescue League of Boston

CAT ADOPTION APPLICATION
NAME: ______________________________________________________
PHONE (H): ___________________________________
ADDRESS: ___________________________________________________
PHONE (C): ____________________________________
APARTMENT: _________________________________________________
PHONE (W): ___________________________________
CITY: ____________________ STATE: _________ ZIP: ________________
EMAIL: _____________________________ __________
Who will be the primary caretaker for this cat? ___________________________________________________________
How many people live in your household? _______________________________________________________________
▫ Yes ▫ No
Do any children live in or frequently visit your household?
If so, what are the ages of the children? _________________________________________________________________
Do you have any concerns regarding pet allergies in your household?
▫ Yes ▫ No
If yes, please specifiy: _________________________________________________________________________
Have you ever owned a cat before?
▫ Yes ▫ No
If yes, how long ago? _________________________________
If you currently have any pets, please list them below:
NAME
AGE
BREED/TYPE
GENDER
SPAYED/NEUTERED
1) _____________________________________________________________________________________________________________
2) _____________________________________________________________________________________________________________
3) _____________________________________________________________________________________________________________
Who is your current veterinarian? __________________________________________________________________________
When was the last time your current pets had a veterinarian visit for vaccinations? ______________________________
Have you ever had to give up a pet before?
▫ Yes ▫ No
If yes, why? __________________________________________________________________________________
▫ Less than 4 ▫ 4 - 8 ▫ 8 - 12 ▫ 12+
▫ Indoor Only ▫ Outdoors when supervised ▫ Indoor/Outdoor ▫ Outdoor Only
I plan on my cat being:
▫ Very High ▫ High
▫ Moderate
▫ Low
▫ Very Low
I prefer a cat whose energy level is:
▫ A few times a week ▫ Daily ▫ I will bring them to a groomer
I would prefer to brush my cat: ▫ Rarely
▫ Playful ▫ Talkative ▫ Quiet ▫ Declawed
Please select any qualities you are looking for in a cat:
▫ Affectionate ▫ Independent ▫ Low-Shedding ▫ Mouser ▫ Lap Cat ▫ Other: ______________
What is the average number of hours your cat will be left home alone?
Today we will be discussing basic cat care. Please select any additional topics you would like to cover:
▫ Declawing ▫ Indoor vs. Outdoor ▫ Appropriate Toys ▫ Lifespan ▫ Grooming ▫ FELV & FIV
▫ Introducing to Other Pets
▫ Cats & Children
▫ Other: _________________________________________
▫ Own ▫ Rent ▫ Other
Do you own or rent?
If you rent, by signing here you are confirming that the landlord at the above described address allows you
_______________________________________ to keep animals at the leased premises.
(name)
The Animal Rescue League of Boston may perform random home visits to follow up on the care of the animals it places, or or
or prior to the adoption approval to establish if a home is an appropriate fit for the animal. Do you agree to allow the
Animal Rescue League of Boston to perform home visits?
▫ Yes ▫ No
The Hills Company is working with the Animal Rescue League of Boston to improve our services. Do you agree to
receive addtional coupons and information from the Hills Company?
▫ Yes ▫ No
I certify that all information given is accurate and truthful. I understand that falsification of any information will result in automatic refusal of
adoption or confiscation of the animal. I also understand the right that the Animal Rescue League of Boston reserves to deny any application.
Signature: __________________________________________________________________________________________
Print Name: ___________________________________________________________ Date: ______________________
FOR STAFF USE
INTERVIEWED BY (please list your name if you have had any discussion with this potential adopter):
1) _____________________________________________________________________________________ DATE: _______________________________
2) _____________________________________________________________________________________ DATE: _______________________________
TOPICS COVERED:
▫ Scratching furniture
▫ Indoor/outoor
▫ Litterbox Issues
▫ Diet & Feeding
▫ Hiding
▫ Declawing
▫ Routine veterinary care / Cost of care
▫ Surrendering past pets
▫ Intro to other cat in home
▫ Intro to dog in home
▫ Cats and children
** Please check off topics discussed and circle topics that require more discussion
PET(S) THEY ARE INTERESTED IN ADOPTING - PLEASE LIST NAME AND A#:
1) _____________________________________________________________________________________ DATE: ________________________________
2) _____________________________________________________________________________________ DATE: ________________________________
ID#: ________________________________________________________________ DOB: _____________________ EXP DATE: _____________________
DOES THIS ADOPTER:
▫
Own their home
Approved:
▫
▫
▫ Yes
Rent
▫
Other
▫ No
▫ Approved with restriction:
____________________________________
THIS ANIMAL IS ON HOLD FOR THEM UNTIL:
Date: ________________________________________________________________ Time: ____________________
For:
▫ Meet family/roomates
▫ Personal identification
▫ Meet other dog
▫ Behavior team approval
▫ Final decision
Other special hold information: _____________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
▫
THERE IS NO HOLD ON THE ANIMAL AT THIS TIME
NOTES:
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