HSCC Adoption Application
What is the name of pet you are interested in adopting? *
Applicant's Name *
Email Address *
Phone Number *
Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Do you own or rent your home? If you rent, please provide the name and telephone number of your landlord. *
Do you have children under the age of 12 living in your home or that visit often? *
Are all family members in favor of adding a pet to the household? *
Please list your veterinarian's name and any pets cared for by this veterinarian in the past five years. *
Veterinarian's Phone Number *
If pets are currently living in the home, please list name, breed, and age of each pet.
Are all of your pets spayed/neutered? If not, please explain. *
Do you use heartworm and flea/tick preventatives regularly? *
Please list the name of the product you use.
Do your current pets get along well with other dogs and/or cats? *
How will you contain your pet when outdoors? *
If you have a fenced yard, what is the type and height of the fencing? Approximately what size is your fenced yard? *
When your pet is outdoors, how will you provide for shelter, interaction with family, and safety? *
When your pet is alone, how will you provide for containment and entertainment so the pet does not become destructive? *
How would you handle behavior problems in a pet? *
Under what circumstances would you return the pet to HSCC? *
How much do you estimate it will cost for annual care of a healthy pet? *
Are you financially able to provide basic healthcare plus treatment of future illnesses/accidents? *
If your dog tests positive for heartworms during regular adoption services, are you able to pay for treatment, which can range from $50-$300? *
Heartworms are caused by mosquitoes and should be prevented with a monthly pill purchased from your vet.
Please add any additional information that you believe may be useful.
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