Paws Along the River Online Pre-Adoption Form

Adopting a pet is a process with many steps that are designed to protect the animals and ensure a good match for both the humans and the animals, and ultimately find a good forever home for the animals. Everything we do is for the best interest of the animals in our care and is aimed at giving them a second chance to find a permanent home. This form is designed to help our staff help you in choosing the best match.

Photos will be required at the end of this form. We ask that you have at least 3 photos of entire rooms inside the home where the pet will live, Living room, kitchen, family room and bedroom. 2 outside photos, one of the back of the home and one of the front of the home in daylight, please. Additional photos are welcomed.

Do you live outside of the Warren area? Yes No

Let's get Started

Todays Date

Who are you interested in:

Full Name

Email Address

Phone Number

Is there a co-applicant? Yes No

Co-Applicant's Name

City

State

Zipcode

Address

Your Household (select all that apply)

How long have you lived at this address?

Will you be moving in the next year Yes No

Home type: House Apartment Upstairs Downstairs Mobile Home

Living Arangements: Rent Own Lease Option to buy Rent Land in a Park

Co-Occupants Spouse/Partner Roommates Children Parents Children Alone

Household size

How many Adults?

How many Children?

Childres Ages

How many Roommates?

Do you have a Landlord? Yes No

Landlord's Name

Contact phone number

Who are you adopting for? Self Children As a Gift Whole Family Companion for other pet Other

Who will be primarily responsible for the care and supervision of the pet?

Do children other than your own visit your home? Yes No

When do they generally visit?

Do grand children come over to visit your home? Yes No

How Ofen and what are their ages?

Are you over 21 Years of Age? Yes No

Are you a Student? Yes No

Occupation

Place of Employment

Full or Part Time Full Time Part Time

What Shift? Days Evenings Nights

Spouse/Partner Occupation

Spouse/Partner's Occupatoin

Place of Employment

Full or Part Time Full Time Part Time

What Shift? Days Evenings Nights

Misc Are you Retired? Receive SSI? Receive Disability Income?

How did you hear of us? Pet Finder Website Friend Previous Adoption Radio Ad? Other

Please tell us how!

What kind of pet are you applying to adopt?

Dog Adoption Section

Why do you want to adopt this animal?

What type of dog do you prefer? Active Calm House Broken

Do any household members have a known alergy to dogs? Yes No

Are ok with Shedding? Yes No

What size dog do you prefer? Tiny (1-10lbs) Small (10-25lbs) Meduim (25-50lbs) Large (50-100lbs) No Preference

is this your first dog? Yes No

List the breeds of dog's you have in the past:

Where did your dog sleep?

Where will you keep the dog when your are not home?

Where will you keep the dog at night?

Where will you keep the dog when left alone?

What would you do with the dog if you went on vacation or emergency?

Do you have experience with crate training? Yes No

How many hours a day will the dog be without human companionship?

Have you ever had a bad experience with a dog? Yes No

Please tell us about it!

Cat Adoption Section

As an adult, have you owned a cat? Yes No

What type of cat would you prefer? Active / Lively Calm / Less Active

Is this pet going to be a surprise? Yes No

Are you a Student? Yes No

Why do you want to adopt this Cat / Kitten?

What kind of Cat will it be used for? House Pet Barn Cat Mouser Other

Please describe what your cats role will be.

Will you be introducing your cat to a current cat or dog?? Yes No

Other Pet Adoption

Are you over 21 years of age? Yes No

Is this pet a surprise for someone? Yes No

Are you a Student? Yes No

Why do you want to adopt this Pet?

Will you be introducing your cat to a current cat or dog?? Yes No

Veterinarian Records

What Veterinarian Clinic do/will you use?

Clinic Phone Number:

What name are your records listed under?

Please list all current pets in the the home.

This is my first pet.

Current Pet #1

Type / Breed

Age

Sex

What happened to them?

Fixed? Yes No

Vet Clinic

Add another? Yes No

Current Pet #2

Type / Breed

Age

Sex

What happened to them?

Fixed? Yes No

Vet Clinic

Add another? Yes No

Current Pet #3

Type / Breed

Age

Sex

What happened to them?

Fixed? Yes No

Vet Clinic

Add another? Yes No

Current Pet #4

Type / Breed

Age

Sex

What happened to them?

Fixed? Yes No

Vet Clinic

Image Uploads

Specific photos are required for anyone interested in adopting from PAWS. Please send clear photos to show where a new pet will live. Your form will be processed only after all information is received in our office.

Inside Image 1

Inside Image 2

Inside Image 3

Outside Image 1

Outside Image 2

Applicant Signature

In order for our staff to fulfill our adoptions policy requirements veterinary records must be released. I hereby authorize the release of my veterinary records pertaining to the health and care of pets owned by myself currently and in the past to the Paws Along the River Humane Society.

*The Humane Society staff reserves the right to request a home check by staff and/or to deliver the pet to your home.

I CERTIFY THAT THE ABOVE IS TRUE AND UNDERSTAND THAT FALSE INFORMATION MAY RESULT IN NULLIFYING THIS ADOPTION.

I understand this questionnaire remains the property of PAWS.

I have read and agree to the statement above.

Please type your full name in the box to sign.

Thank you for submitting an application for adoption with Paws Along the River Humane Society of Warren. We choose homes based on the needs of each animal. Please be patient with us and allow our staff to show you several pets.