Pre-Adoption Form

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

(By providing this information, you may receive communications from Northeast Animal Shelter)

Phone*

Do you own or rent your home?*

Own
Rent

If you answered 'rent,' please provide your landlord's name and phone number.*

How long have you been at this address?*

Are you planning to move?*

Yes
No

When do you plan to move?

Does your lease allow pets?*

Yes, cats only
Yes, cats and dogs
No

Are there other pet restrictions under your lease?*

Certain breeds not allowed
Large dogs not allowed
Landlord's approval required

How would you describe your home?*

Single-family house
Multi-family house
Apartment
Condo/Town house

What is your household activity level?*

Quiet as a library
Grand Central Station
Somewhere in between

What is your experience as a pet owner?*

First-time owner
Have had 1 or 2
Knowledgeable and experienced

What children will be at home?*

None
Sometimes children visit
1 or more children under 13
Children & Teenagers
Teenagers, but no young children

List all people who will be living with the new pet*

Please list names, ages, and relationships

Who will the new pet be for?*

Myself only
My family

Who will be the primary caregiver?*

Myself
My family

Is anyone in your home allergic to cats or dogs?*

Yes, cats only
Yes, dogs only
Yes, cats and dogs
No

Tell us about your typical day*

Please let us know if you expect the pet will be home alone for more than a few hours

Tell us about a typical day for others in your household*

References & Alternate Contacts*

Please list two people who could be used as references and/or contacts in case of emergency. Include name, city, state, and phone number.

What kind of pet are you thinking about adopting?*

Kitten
Cat
Puppy
Dog

Please tell us in as much detail as possible what you are looking for. Do you have a preference of male vs. female? What kind of temperament/personality characteristics are you looking for? What about physical characteristics? For canines for example, what full-grown size range or coat would work for you? For felines, do you prefer short or long-haired?

If you are looking for a kitten or cat, will it be declawed?*

Yes
No

Will the pet be allowed outside by itself?*

Yes
No

Where will the pet be when outside by itself?*

In a fenced yard
In a pen
In a crate
Tied up
On a runner
Allowed to roam outside the yard

How many hours at a time will the puppy/dog be left alone outside?*

When inside, the puppy/dog will be:*

in a crate
in limited room(s)
free to roam the house

Tell us about other pets you have owned

Please indicate if you still own the pet, name, cat or dog, age, breed, spayed or neutered, current with vaccines, and if no longer owned, what happened?

Pre-Adoption Form

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