Fill and Sign the Physician Consent Form

SAVING PETS ONE AT A TIME (S.P.O.T.) P.O. Box 211, Burlington, WA 98233 Telephone: 360-336-5388 Fax: 360-766-7804 ADOPTION APPLICATION Thank you for filling out this application. This information will help us to get to know you and your family better. Date: Which pet are you interested in? Your name(s): Your Address: Daytime Telephone: Evening Telephone: Your Email Address: How long have you lived at your current address? Where did you previously reside? Do you reside in a house, mobile, apartment? Do you own or rent? If you rent, we will need the following information: Landlord s Name: Landlord s Telephone: Place of Employment: Will this be your first pet? Do you currently have cats? Breeds/Ages: Do you currently have dogs? Breeds/Ages: Any other domestic animals (describe): Any livestock (describe): Are there children in the household? Ages: Do children frequently visit your home? Ages: Where will your pet spend the most time during the day? Where will your pet spend the most time during the night? If applying to adopt a dog, do you have a fenced yard? Type of Fence: Is the yard fenced completely around? Dimensions of fenced area: What function will your pet play in your life (ex: companion, working, etc.): Are there any behaviors you would have a hard time dealing with in your new pet? Would you object to S.P.O.T. sending a representative to visit your home before and/or after adopting a pet from them? If yes, why? Are you aware of your city and/or county regulations regarding pet ownership, such as licensing issues and/or leash laws? If you are interested in adopting a cat, do you plan on having it declawed? Why? Are you aware that all pets adopted from S.P.O.T. are spayed/neutered and vaccinated prior to the adoption process being complete? Do you have any objections to this policy? Are you willing and able to financially support the adoption of the pet you are interested in: Are you thus aware that this pet will need annual booster vaccinations for optimum health? Who is your current veterinarian or clinic? Please feel free to include any additional comments or information about yourself on a separate sheet of paper. Please note: This application is a starting point in the adoption process. S.P.O.T. adoption counselors will use this information to evaluate your lifestyle and the preferred lifestyle for the pet in question. Not passing the qualifications for one pet does not mean that a different pet will not work for your situation. Your patience with this adoption process is greatly appreciated. Our goal is to find the perfect pet for your needs and the perfect home for each pet in our care. Thank you.