Adoption Questionnaire

Paws Crossed Animal Rescue Inc - Adoption Application

Healing hearts one paw at a time.
Full Name

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState

Post codeCountry
E-mail
Phone Number

phone number
Have you ever given away a pet before for any reason? please explain
Birth Date

MonthDayYear
Residence

Other
How long have you lived at you current residence?
How long to you plan to stay at this residence?
If you do move in the future, what are your plans for your animals?

List all other people living in your home.

Is anyone in your home allergic to animals?
Name of your veterinarian or veterianry Hospital/Clinic:
Phone number of your veterinarian:

phone number
The animal you are interested in:
I want to adopt a

Other
Name of specific animal you're interested in (if any):
Age of pet wanted

Other
I prefer a
This animal needs to get along with:
This animal will be

Other
I prefer an animal with an activity level that is:
What type of personality are you hoping for in your new pet?
What concerns , if any do you have regarding adopting this animal?
Will your pet spend any time outside? How much?
What food or foods do you anticipate feeding your new pet. (Suggestions available)
Are there any behaviors this animal could have that would be totally unacceptable to you?

Please tell us about the animals you have now.

Paws Crossed Animal Rescue Inc - Adoption Application