Humane Society For Hamilton County
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Adoption Application
Please note, we are located in Fishers, Indiana, USA.
Step
1
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7
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TELL US ABOUT YOURSELF
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
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State
ZIP Code
Email
*
Driver's License Number
*
Date of Birth
*
Month
Day
Year
Cell/Other Phone
*
Home Phone
Optional
Work Phone
Optional
Occupation:
*
Emergency Contact
*
Please, list someone other than yourself.
First
Last
Emergency Contact Phone
*
Are you at least 18 years of age?
*
Yes
No
How did you hear about the shelter or the animal you'd like to adopt?
*
Shelter Website
PetSmart
Petco
Facebook
Instagram
Twitter
TV/News
Radio
A Shelter Email
HSHC Event
Pets Healing Vets
Pet Finder
Google or Other Search Engine
Other
Please Explain:
*
Areas of Interest
I am interested in adopting a:
*
Cat
Specific Cat
Dog
Specific Dog
Either
Name of the cat or dog you'd like to adopt.
*
TELL US ABOUT YOUR HOUSEHOLD
Tell us about your current housing situation
*
Own my own home
Own my own condo
Renting an apartment/condo
Renting a house
Living with parents/relatives
Live in a trailer/mobile home
College Fraternity/Sorority Housing
How long have you lived at this address?
*
Landlord/Homeowner's Name:
*
First
Last
Landlord/Homeowner's Phone Number:
*
Does your landlord/homeowner have any breed or weight restrictions?
*
Please be advised that HSHC requires a copy of your pet policy.
Yes
No
Is there a pet policy with breed or weight restrictions in your community?
*
Please be advised that HSHC requires a copy of your pet policy.
Yes
No
TELL US ABOUT YOUR FAMILY & VISITORS
Please tell us about your current household
*
Live Alone
Adults Only
Family with children
Please, list the ages of all individuals living in your home including yourself.
*
Click the "+" on the right of the row to add additional rows.
Age
Is any member of your household allergic to animals?
*
Yes
No
If yes, they are allergic to:
*
Cats
Dogs
Both
Do you have visitors often?
*
Yes
No
What is the frequency of visitors in your home?
*
e.g. Babysitters, Nannies, Extended Family, Significant Others, Neighbors, Friends, etc.
Are there children/grandchildren who visit your home REGARDLESS OF FREQUENCY?
*
Anyone under the age of 18 is considered a child.
Yes
No
Please, list ages of each child that visits and how often they visit.
*
Age
Visit Frequency
Do you anticipate the addition of new household members in the near future?
New baby, Parents/Siblings moving in, Roommates
Yes
No
The activity level in your home is
*
Quiet
Active
Very Active
Matchmaking Questions
Do all members of your household know you are planning on adopting a pet?
*
Yes
No
Please tell us why you want to adopt a pet
*
Select all that apply.
Companionship for me/myself
Companionship for my current pet(s)
Protection
Watch Dog
Breeding
Mouser
He/She will be a gift
ESA/Service Animal
Please, explain.
*
Please tell us what type of pet you are looking for:
*
Indoor Pet
Outdoor Pet
Indoor/Outdoor Pet
Please Explain:
*
Dealbreakers
*
Would any of the following be a dealbreaker for you?
Dog/Cat MUST LIVE with Other Dog(s) in the home
Dog/Cat MUST LIVE with Other Cat(s) in the home
Dog/Cat MUST Get along with Other Dog(s)/Cat(s) outside of the home
Dog MUST be able to go to public settings (bars, pet stores, etc.)
Dog/Cat MUST be good with children living in/visiting the home
Dog MUST be easy to walk/control
Dog/Cat MUST be fully housebroken/litterbox trained
Dog MUST be crate trained
Dog CANNOT create a noise issue with close neighbors
Cat MUST be declawed
Cat MUST be appropriate for outdoor living
Dog/Cat MUST NOT require professional grooming
Dog/Cat MUST be low shedding
Dog/Cat MUST NOT have any serious behavior/medical issues
None of the above
Other
Please, explain:
*
When you ARE home, where will your pet spend the majority of their time?
*
Check all that apply
Loose within residence
Crate within residence
Garage
Basement
Fenced Yard
Outdoor Kennel
Tie-Out In Yard
Other
Please Explain
*
When you are NOT home, where will your pet be confined?
*
Check all that apply
Loose within residence
Crate within residence
Garage
Basement
Fenced Yard
Outdoor Kennel
Tie-Out In Yard
Other
Please Explain
*
If you have a fenced in yard, what kind is it? (e.g. Invisible, 4 ft chain link, 6 ft privacy, farm fencing, etc.)
*
If you do not have a fence, please put "N/A" in the box below.
What will you do with this pet when you travel/go out of town?
*
Boarding Facility/Vet's Office
Family or Friends Watch Them
Leave Home Alone
Take With You
Other
Please Explain
*
Are there any other dogs/cats who live outside the home that your new pet MUST get along with?
*
e.g. relative's dog, neighbor's dog, significant other's dog, etc.
Yes
No
If yes, please explain:
*
What training methods and/or training facilities would you use to address potential issues that may arise with your new pet?
*
e.g. Barking and/or meowing excessively, crate training issues, chewing/scratching, housebreaking, litter box issues, fearful behavior with new people, etc.
What leash and/or walking tools do you plan on using in the home or on walks?
*
e.g. 6ft Nylon Leash, Retractable Leash, Gentle Leader, Harness, Slip Lead, Prong Collar, Choke Chain, etc.
Do you have plans to declaw your adopted/cat kitten?
*
Yes
No
If yes, why?
*
TELL US ABOUT YOUR PETS
Do you currently have any pets?
*
Yes
No
Current Pets
*
Breed/Mix
Sex (M or F)
Age
Spayed/Neutered? (Yes or No)
Length Owned?
Name of your Veterinarian Or Clinic
*
Please put "N/A" if not applicable
Veterinarian's Phone
If one of your current pets is not spayed/neutered, please explain why.
*
Please put "N/A" if not applicable
If one of your current pets is not current on vaccines, please explain why.
*
Please put "N/A" if not applicable
Please tell us about your PAST pets (adult life only - past 10 years).
Have you ever surrendered or rehomed a personal pet to this or any other shelter/rescue group?
*
Yes
No
Please, explain.
*
In the past 10 years, have you had any pets you no longer own (e.g. passed away, rehomed, run away)?
*
This does not include pets your parents owned when you were under 18 years of age.
Yes
No
Past Pets (adult life only - past 10 years)
*
Breed/Mix
Sex (M or F)
Spayed/ Neutered? (Yes or no)
Length Owned?
What Happened? (e.g. Died, Rehomed)
Age at Death, Rehoming, Etc.
Planning Ahead
Owning a pet, at a MINIMUM, can be a 10 year commitment.
*
Do you have any questions or concerns with this time commitment?
No
Yes
If yes, please explain:
*
The average annual budget to provide basic care for a pet is estimated at $1,500/year, not including medical issues that may arise.
*
Do you have any questions or concerns with this financial commitment?
No
Yes
If yes, please explain:
*
Are you planning to move or change jobs in the next 3-6 months?
*
Yes
No
Please explain what will happen with your new pet at that time.
Next Steps!
We appreciate your time and interest in adopting a pet from us. Please note that the purpose of this application is to learn more about you so that we can match you and your family with the right, life-long pet.
THE NEXT STEP
is for you to come visit us so we can discuss and then introduce you to possible candidates. We will keep your application on file for 6 months. By signing below, you acknowledge this is not the approval or guarantee of a pet adoption from our facility, but rather, the first step in helping us match you with the perfect pet.
Signature
*
Please type your legal name.