Humane Society of Pagosa Springs

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PRE-ADOPTION QUESTIONNAIRE

Please take a few moments to read the following explanation of our adoption policies and the steps that make up the process. You may be surprised that adopting an animal is a more involved process than you expected. The process is the same one for everyone, and it's not our intent to frustrate you. Everything we do is for the best interests of the animals in our care and is aimed at giving them the best possible chance of finding a permanent home. Please bear with us and be patient.

Here are the steps you'll go through in the adoption process:

In order to assist you in finding your new pet, please complete the pre-adoption questionnaire.
Submit questionnaire online or bring with you to Humane Society Animal Shelter.
Once all the paperwork has been completed, our staff will accompany you and fill you in on the history of an animal. Please feel free to ask any questions you might have about bringing a new animal home.
All adoptees are required to sign an adoption contract and pay an adoption fee. The adoption fee covers all initial shots except rabies. (Rabies must be administered by a veterinarian.) All adopted animals must be spayed or neutered prior to going home. An appointment at a local veterinarian will be scheduled at the earliest date and shelter personnel will deliver the animal to the veterinarian on the proper date.

Please Note: Due to our limited kennel space, we cannot hold animals for anyone nor can we board animals after being adopted. Because of the tremendous demands on our kennel space, all adoptions must be done on a first-come, first-served basis. The first good, properly qualified prospective home will be able to adopt the pet.

Thank you for your cooperation.

Name:
Email:
Physical Address:
Mailing Address:
City: State: Zip:
Home Phone: Business Phone:
House Apartment
Other: Own Rent
If you rent, provide name and phone number of landlord:
Number of children in your household and their ages:

Every potential adopter is required to fill out this form before being considered for a pet. (To save time, you can fill in and submit (select Submit button at end of form) or print out this form and bring it with you when you visit the Humane Society Animal Shelter.) This information will help us to make the adoption experience a good one for you and for the dogs and cats in our care. Please bear with us and be patient. The Humane Society of Pagosa Springs reserves the right to refuse any adoption.

Are you interested in adopting a: Dog  Cat
  Name(s) of Animal(s) You Are Interested In:

List other pets you currently own:
        Dog/Cat - Age - Spayed/Neutered? - Length of Time Owned

List pets you have owned in the past five (5) years, but no longer have:
Dog/Cat-Spayed/Neutered?-Length of Time Owned-Reason No Longer at Home

Who is your veterinarian? Telephone Number (local or long distance)

Provide three personal references - Names and phone numbers:

Is everyone in your household aware that you are considering pet adoption? Yes  No
  If not, explain:
Is anyone in your household allergic to animals?
Will this animal be given as a gift? Yes  No
Do you plan to care for this animal for its lifetime? Yes   No
Who will be the primary care-giver providing food, water, training and veterinary care?

Will you keep this pet: Indoors  Outdoors  Indoors & Outdoors
If the pet will be kept primarily outdoors, will it be: Chained   Fenced   Unrestrained
What type of outdoor shelter will be provided?
How many hours a day will the pet be left alone?
Will you have your pet vaccinated as needed for rabies and other pet diseases? Yes  No
If you move, will you take the pet with you? Yes  No

I verify that I have answered the above questions truthfully and accurately. I agree to allow an agent of the Humane Society of Pagosa Springs or their representative access to my property at any time for pre-adoption AND post-adoption visits. I agree to allow an agent of the Humane Society of Pagosa Springs to remove from my premises any animal or animals adopted from their shelter if information I have provided is found to be false, or if my situation or ability to provide proper care for the animal(s) changes and the conditions for the animal(s) is deemed unsuitable.

Signed: Date:

(Select Submit to send completed questionnaire to Humane Society Animal Shelter by email.)

(Clears form.)

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*- Animal Shelter -* Hours: Mon.-Sat. 10am-5pm, Sun. 10am-4pm Address: 465 Cloman Blvd., PO Box 2230, Pagosa Springs, CO 81147 (Map) Phone: (970)731-4771 FAX: (970)731-5552 E-mail: sheltermanager@humanesociety.biz	*- Thrift Store -* Hours: Mon.-Sat. 9 am-6 pm, Sun. 10 am-5 pm Address: 269 Pagosa St on Hwy 160, PO Box 2230, Pagosa Springs, CO 81147 (Map) Phone: (970)264-6424 FAX: (970)264-5593 E-mail: hsthriftstore@humanesociety.biz	*- Administrative Office -* Hours: Mon.-Fri. 8am-5pm Address: 269 Pagosa St on Hwy 160, PO Box 2230, Pagosa Springs, CO 81147 (Map) Phone: (970)264-5549 FAX: (970)264-5593 E-mail: hsadmin@humanesociety.biz