Application to Adopt - Page 3
Name of Veterinarian? _____________________________Phone Number______________
Are you willing to let us call your vet's office to see if your pet's shots are up-to-date? _______
Will you use this vet for your new pet? ______If not, who? _______________________________

Dogs and cats often live longer than 15 years. Are you prepared to take responsibility for this pet for it's entire lifetime? _______yes           _______no

It may take your pet a month or longer to adjust to a new home. Are you willing to allow him this much time for adjustment?  ________yes         _______no

If you already have pets they will probably resent any new ones that you bring into your home. Each new one will upset the established pecking order and both your established pet and the new ones will feel compelled to test their boundaries with each other. Once the pecking order has been re-established to include your new pet, they may become great friends or at the least, learn to tolerate each others presence. Until this happens you may expect some snarling, hissing and even a fight or two. Are you willing to allow time for your pets to adjust to one another?   _______yes       _________no

Do you agree to return the pet to us if you can no longer keep it?  ___yes     ___no

Are you willing to let a representative  visit your home by appointment? ___yes   ___no

Have you wever adopted from a shelter before?    _____yes     ____no
If yes, name of shelter or organization _____________________________________________

Have you ever released an animal to a shelter?  ______yes      ______no
If yes, explain ___________________________________________________________________

By signing below, I certify that the information provided on this application is true and I recognize that any misrepresentation of facts may result in losing adoption privileges.

Applicant signature_____________________________________________Date _____________

Spouse or other adult signature __________________________________Date _____________


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TO SUBMIT: We're sorry that at this time we do not have the application set up on the web page for automatic submission. Please attach to an e-mail and send to pfs@ocslink.com or print out and mail to Pets for Seniors, 12115 Southport Rd., Brimfield, IL 61517