THR Pre-Adopt Cat

Tender Heart Rescue

Cat Pre-Adoption Application

Please provide detailed information for all questions. Our adoption fee includes age appropriate vaccinations, spay/neuter, microchip,and any other medical care the pet needed before adoption.

To qualify you must:

- Have the knowledge and consent of a landlord, if relevant

- Be able and willing to spend time and money necessary to provide medical treatment, proper
nourishment and care, and training for a pet.

Please Note: We reserve the right to refuse adoption to anyone. Please be advised that we will not adopt to persons who mislead or fail to provide accurate information on this application.

Adopter's Name: *

Pet(s) Interested In: *

Street Address: *

City: *

State: *

Zip: *

Email Address: *

Phone Numbers: (h) *

How many adults live in the household other than yourself? *

How many children live in the household? *

Are all members of your household aware of and in agreement of this adoption? *

Yes

Do you: *

Own

Rent

Live with Parents

Other Other

Landlord's Name & Phone Number if Renting:

Number of Pets Allowed:

If you rent, does your landlord allow pets?

Yes

How many pets are allowed?

How far from the road/traffic is your home located? *

Is the volume of traffic: *

Light

Moderate

Heavy

Other Other

Do you plan on moving in the foreseeable future or do you have a job that may require relocation? *

Yes

Other Other

If yes, what will you do with your new pet?

Why do you wish to adopt this pet? (Check all that apply) *

Love animals/want to help a pet in need

Feel sorry for him/her

The animal is so cute, I can't leave it behind

Companionship

My children will learn to be responsible for/care for another creature

Looking for a mouse/rodent control for home or property

Want to breed

Gift for someone

Companionship for another pet

Are you willing to provide regular vet care for your pet? *

Yes

What is your estimated annual cost for vet care? *

Please provide a description of what you consider annual/routine vet care: *

Who is your current or past veterinarian? Please list phone number(s). *

If you do not have a relationship with a veterinarian, who do you plan to use for your new pet?

List names and breeds of all animals PAST and PRESENT. This is needed for the vet check. *

Are your current pets up to date on all their vaccinations? *

Yes

Other Other

Are your current pets on heartworm prevention? *

Yes

Other Other

What type of heartworm prevention do you use? *

Are your current pets on flea/tick prevention? *

Yes

Other Other

What type of flea/tick prevention do you use? *

Have your current cats been feline leukemia and FIV tested? *

Yes

Other Other

How many hours per day will your pet spend alone? *

Where will your pet stay when home alone? *

Do you plan on letting your new pet outdoors? *

Yes

Other Other

How will your new pet be cared for when you are out of town? *

What precautions would you take to properly introduce a new cat into your home if you have other animals? *

What will you do if your new cat doesn't get along with your current pets? *

What behaviors are you not willing to tolerate from a pet? *

What will you do to correct the behaviors you have listed? *

Please list the name and age of who will be primarily responsible for your new pet: *

Have you ever re-homed or taken your pet to an Animal Shelter? *

Yes

Other Other

If you are no longer able to keep the animal you adopt, do you agree that you must return the animal to TenderHeart Rescue? *

Yes

Other Other

Furthermore, do you agree that if you cannot keep the animal you adopt, that you must house this animal until a suitable home is available or until a foster home becomes available? *

Yes

Other Other

By signing this form, I acknowledge that all information on this form is true and correct. I understand that any misrepresentation of fact may result in TenderHeart Rescue refusing adoption priveleges to me. If my request for adoption is approved and later TenderHeart Rescue discovers the above information is not true or correct, TenderHeart Rescue reserves the right to remove the adopted cat from my home.

Adopter's Signature: *

Date: *