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Adoption Form

If you are interested in a specific animal, please include their name below. If this is a general application, you can leave this space blank.

If you don't have a specific animal in mind, which of the below are you considering?

Puppy (under 1 year)
Adult Dog (over 1 year)
Kitten (under 1 year)
Adult Cat (over 1 year)

First Name

Last Name

Date of Birth

Phone Number

County of Residence - Please list the County in which you live, not the State

Address

Address Line 1

Address Line 2

City

Country

Select

State/Province

Select

Zip Code

How long have you lived at your current address?

Is this the address where the pet will be living?

Emergency Contact Name (somewhere other than yourself)

Emergency Contact Phone

Emergency Contact Email

Please note all fields are required. If the question does not apply to you type in N/A ( OR ) choose N/A in the drop down box.

Did you ever adopt from us or any other organization?

Employer

Employer Phone Number

Do you have any children living with you?

What are their ages?

Have the children been around animals?

Does anybody in the family have allergies to animals?

Do you currently have any animals? How many?

Name of animal(s)

Dog/Cat/Other

Age(s)

Breed

Are all of your animals up to date on vaccinations? List animal names.

Do you animals have any health issues?

If you answered yes above, please explain

Are your animals current on their preventive medications including flea, tick, and heart worm?

Are your current pets spayed or neutered?

Yes
No
Both yes and no
NA

Which pets are spayed or neutered?

Which pets are NOT spayed or neutered?

If not spayed or neutered, why?

Who is your current Veterinarian?

Current Vet Phone Number

Upload medical information about current animals in the home, including rabies, spay/neuter, preventives such as flea, tick, and heart worm

Browse (no files uploaded)

File Upload

Browse (no files uploaded)

File Upload

Browse (no files uploaded)

File Upload

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The SPCA reserves the right to contact your veterinarian for a reference and follow-up questions

Where do your current animals live primarily?

Indoors
Outdoors
Indoors and Outdoors

Where will your new pet live primarily?

Indoors
Outdoors
Indoors and Outdoors

Landlord's Name

Landlord's Phone Number

Landlord's Email

Do you have a fenced yard?

Please describe type of fence

Did any of your previous pets die?

Cause of death?

If this application is not for a specific animal, please tell us what type of pet you want including personality, size, and breed mix.

If you are interested in a puppy, what size do you want the dog to be when it is an adult?

Check all that apply

Small (less than 25lbs)
Medium (26-50lbs)
Large (over 50lbs)

Why do you want a new pet?

Where will the animal be kept during the day?

Is anybody home during the day?

Their name:

Can they handle the animal?

Where will the animal be kept during the night?

Where will you keep your animal when you are away for a while?

Who will take care of the animal during vacations?

Are you willing to take the time to work with the animal to become housebroken?

Do you understand it can take a while (weeks to months) for the animal to become adjusted and integrated into your family?

Do you understand animals need regular veterinary care?

How much are you willing to spend on veterinary care?

Are you interested in learning about pet insurance?

What do you feel as a valid reason to give a pet away? (please list all that apply) Fleas / too expensive / shedding / scratches or chews furniture / new place that does not allow pets / moving to another state / getting married or divorced / having a baby / unwilling to take care of animal anymore

If you are unable to take care of the animal, what do you plan to do with it?

If you had or have an animal, what type of problems did you encounter with them?

What did you do about these problems?

What happened to any previous pets that you have owned but are no longer with you?

Did any animal ever get stolen, lost, disappear or die at an early age, please describe the circumstances.

Have you ever given away or surrendered an animal?

Describe your lifestyle. Are you active?

What type of exercise can you provide for your pet each day?

Because the SPCA of the Triad is trying to find the best match for our animals we reserve the right to turn down any potential applicant.

There is a processing time to allow us to check with your landlord and veterinary to make sure a pet is permissible. We appreciate your patience.

I certify that I have answered all questions honestly and to the best of my ability. I understand that any misrepresentations of fact may result in removal of the adopted pet from my home

Electronic signature or type your name in. This will be your electronic signature you understand all questions and comments and have answered all questions honestly.

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Thank you for submitting your adoption application

We have received your adoption form and will contact you shortly. If you have any questions or need to make changes to your application, please email us at spca@triadspca.org.

Gratefully,

SPCA of the Triad

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