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Small Animal Adoption Application

Type of Pet Desired: Rabbit Guinea Pig Chinchilla Rat Mouse/Hamster Sugar Glider Bird Reptile
What is the reason for adopting this pet? Companion for other pet For the children Gift Companionship Breeding Classroom Use Other

Personal Information
Your Name (required)
Your Age
Street Address/PO Box
City
State
Zip Code
Home Phone #
Other Phone #
Email Address (required)

Is your home a:
Rented Apartment Rented House Owned House Other
How many adults are in your household?
How many children? Children's Ages:

Does anyone in the household have allergies to animals? Yes No
Is anyone a smoker? Yes No

Veterinary Information Who is your veterinarian?
City in which Vet is located
Vet's Phone #
How often do you plan to take this animal to the vet?
Will you provide preventative as well as emergency vet care? Yes No
Are you prepared to spend over $100 a year for this pet’s vet care? Yes No
Pet Ownership Information Please list animals presently in your household. Please indicate name, species, sex, where the animal lives (in or outdoors) and spay/neuter status. We will contact your vet to verify vaccination and spay/neuter status if relevant to the adoption.

 

Please list animals owned previously in the last 5 years. indicate name, species, sex, where the animal lived (in or outdoors), spay/neuter status, and what happened to the animal.

 

Have you ever owned the kind of pet you wish to adopt? Yes No

Pet Care Information How will you house your pet?
Loose in the yard Loose in the house Indoor Cage Outdoor Cage Other

Please note that for guinea pigs we require the use of a solid-floor cage such as a Cube & Coroplast Cage. Minimum size for one or two pigs must be 7.5 square feet (28"x42"). For rabbits we require the use of pens (dog exercise pens) or solid floor NIC/Cube&Coroplast type cages, minimum size 8 to 16 square feet depending on rabbit size. Petstore-bought cages are generally not acceptable for either species. ACR&S sells pig and rabbit cages very inexpensively ($40 for the basic cage or pen) if you need to purchase one.
Do you already have a C&C cage or pen of the appropriate size?
Yes No
What are the dimensions
If not, do you plan to purchase one from us, or make one yourself?
Buy from ACR&S Make it myself

Where will your pet's cage be kept?

Describe your pet's housing here if it does not fit the above categories:

Who will be responsible for your pet's care?

Are you familiar with this pet's needs for: Food/water Yes No
  Socialization/Exercise Yes No
  Vet Care Yes No

Please list the foods that make up your pet’s diet. Include all pellets, hay, vegetables, and treats, as well as the amount and frequency fed (as in, "1 handful per day" or "two times a week"). For processed pet food, please indicate the brand if possible.

Other Information If you have a preference for an animal of a certain breed, age, or sex; or have any other comments or elaborations about any of your information above, please enter them here:

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