Adoption Package Form in Word

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Dori’s Darlings Cat Rescue, doris.darlings@gmail.com (832-969-8881)
Dori’s Darlings Cat Rescue
ADOPTION APPLICATION PACKAGE
Name of cat(s) interested in adopting if known
Instructions:
1. Fill out both Adoption Application and Adoption Contract.
2. If you currently have pets and have a vet, also fill out the Veterinary Records Release Authorization and
have the vet office fill out the Veterinary Information Release Form. The vet can email the form directly to
Dori via doris.darlings@gmail.com or return them to you and you can submit them together with all the
other forms.
3. Email completed forms to doris.darlings@gmail.com (832-969-8881)
For any questions about the forms, email your questions to thao.trousdale@gmail.com
4. We will contact you for approval of your application.
5. Once approved, pay the adoption fee/donation via the DONATE button anywhere on the website, note
your name and the cat name(s) in the payment. You can also contact Dori for any other methods of
payments you'd like to use.
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The payment must be made WITHIN 3 DAYS OF APPROVAL. This is to ensure that the cat(s) you're
interested in will be put on hold in case other applications come in. If you need more time to finalize
the adoption this will be treated as deposit to hold your cat(s). The deposit is non-refundable, if you
never come back to finalize the adoption and pick up your cat(s) , the deposit will be considered
donation and you can get tax-deductible donation receipt for it.
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Please understand that we work very hard to find homes for our darlings, we need to know you're
serious so we won't hold back our darlings from other potential good homes while waiting for adopters
that do not come back.
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Dori’s Darlings Cat Rescue, doris.darlings@gmail.com (832-969-8881)
ADOPTION APPLICATION
Today’s Date
Full Name
Street Address
City/State/Zip
Home Phone
E-Mail Address
Cell Phone
Work Phone
Driver’s License Number
1. You currently reside in a: House
Apartment
Mobile Home
Condo
2. How long have you lived at the above address
Do you rent or own?
3. If renting, does your lease allow pets?
How Many
If renting, please provide landlord name and phone number
If less than one year and you are renting, where did you live before? (Complete address and phone information)
4. Please list the following information for all persons living in your household including yourself.
Name
Age
Employer & Occupation
Work Schedule
Driver Lic#
Is everyone in your household aware of and agreeable to your interest in adopting?
Do you or anyone in your household have animal allergies?
5. Where will the cat be kept? Indoors
Outdoors
Both
If both, how many hours of the day or night will the cat be kept outdoors?
What will you do with the cat when you go on vacation?
If you or your spouse became pregnant, would you consider re-homing your cat?
What arrangements would you make for your cat in the event of your death?
Do you plan to declaw? Yes
No
Only front claws
All four paws
What would you do if your cat scratched the furniture? Children?
If you were not planning on declawing, what would be reasons that would make you reconsider and declaw?
7. What do you expect to spend on yearly maintenance of your cat? (Food costs, litter, personal items, i.e. toys, bedding,
and veterinary expenses, etc.)
Will you feed your cat: Dry
Canned
Both
Don’t know
What brand(s) do you/ will you feed? Dry
Canned
If your cat became ill and veterinary costs became high, what would you do?
8. What would be the reasons that you would consider euthanizing your cat?
9. What would be the reasons that you would consider re-homing your cat? (Check in front of all applicable options)
___
Having a baby
Getting married or divorced
Allergies
Scratches furniture ______Too
expensive
Children won’t take care of it
Fleas
Sheds too much fur
Found a
new place to live and they don’t allow pets
Girlfriend/ boyfriend doesn’t like cats
Other:
10. Have you ever turned an animal in to a shelter? If yes why?
Have you ever re-homed a cat or released one outdoors?
How many animals have you had as an adult?
How many currently live with you?
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Dori’s Darlings Cat Rescue, doris.darlings@gmail.com (832-969-8881)
If they no longer live with you, what happened to them? (i.e. died, rehomed, euthanized, etc.) Please explain at length
and in detail the specifics of each animal and its outcome, including age, circumstances, expected/ unexpected, etc.
If you have never had a cat of your own, why do you want one now? What history and experiences have you had with
cats?
11. Do you have any pets at the present time?
If yes, please provide the following information:
Name
Breed
Age
Yes
Current on shots?
No
Spayed/ Neutered?
Clawed/ Declawed
12. If you currently have pets, please list name, address, phone number of your current veterinarian:
Dr. _____________________ Address _____________________________________Phone
13. Which kitties are you interested in? (List specific cats or describe what you are looking for in a cat)
14. Please list the names and phone numbers of three references (of those, please list at least two that are non-family
members) with whom we could discuss your adopting a rescued cat:
I certify that the above information is true and accurate and understand that false information or lack of full disclosure of
pertinent information may result in rejection of my adoption application. I understand that no cat is ‘on hold’ for me.
Further, my signature below signifies my agreement to and acknowledgement of Dori's Darlings right to share any and
all information contained in this application, or obtained in the processing of this application with any other rescue
group, adoption agency, shelter organization, or any other person or persons, as deemed reasonable or necessary by
Dori's Darlings to secure the health or well-being of any animal or animals of which applicant has any interest or intent.
Signature
Date
Dori's Darlings, at its sole discretion, reserves the right to deny, refuse, or reject any application for any reason we
deem necessary.
No adoption is final until the adoption fee is collected and the adoption contract is signed by both the adopter and the
Dori's Darlings representative.
Dori's Darlings Representative Signature
PLEASE NOTE INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED
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Date
Dori’s Darlings Cat Rescue, doris.darlings@gmail.com (832-969-8881)
ADOPTION CONTRACT
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4.
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7.
8.
9.
10.
AS THE ADOPTER, I AGREE TO THE FOLLOWING PROVISIONS:
If the cat is not already altered, I agree to have it altered by this date:
I will provide proof of
altering by the designated date and if not delivered, I understand that Dori's Darlings reserves the right to reclaim
the cat.
I agree to obtain all licenses required by local authorities. I agree to register the microchip implanted in this
animal by Dori's Darlings in my name within 30 days.
I agree to provide the Adopted Animal with necessary inoculations at the intervals advised by my veterinarian.
I agree to have the Adopted Animal under my control when he/ she is within the confines of my property. I agree
to keep the cat as an indoor only pet, or to provide a completely enclosed and sheltered area to allow outside
access. The cat will not be tied or chained.
If for any reason I cannot keep the kitty, I agree to notify Dori's Darlings of the availability of the pet and to return
the kitty at our request.
I agree not to abuse or neglect the kitty and authorize Dori's Darlings at their sole discretion to determine whether
or not the kitty has been abused or neglected.
I understand that any failure to perform the foregoing agreement will constitute a breach of contract. In the event
of any such breach of contract, I authorize the Dori's Darlings to reclaim both possession and ownership of the
kitty.
I understand that the cat covered by these adoption papers, is as far as can be determined by Dori's Darlings, in
good health and that the Dori's Darlings is not responsible for any medical fees incurred after the adoption date.
I agree to give the Dori's Darlings visitation rights to ensure that the terms of this adoption agreement are being
observed.
Adoption fees are not refundable.; they are considered a donation toward vetting and maintenance.
I AGREED TO AND UNDERSTAND ALL OF THESE PROVISIONS
Signature of adopter:
Date:
Witness name and signature:
Date:
Disclaimer: Please understand that our rescue group takes cats off the street and from high kill shelters, and other
sources in which specific prior history cannot be ascertained. We provide vetting as follows: Spay or neuter, FVRCP,
Rabies, one time dewormer, apply Advantage and microchip.
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Dori’s Darlings Cat Rescue, doris.darlings@gmail.com (832-969-8881)
VETERINARY RECORDS RELEASE AUTHORIZATION
To be filled out by applicant
Client Name
Home Address
Home/Cell Phone ________________________________ Work Phone
Please release any and all veterinary records and information pertaining to my past and current pets to
Dori's Darlings for purposes of obtaining a veterinary reference.
Client Signature ___________________________________ Date _________________________________
APPLICANT MUST FILL OUT THE VETERINARY RECORDS RELEASE AUTHORIZATION
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Dori’s Darlings Cat Rescue, doris.darlings@gmail.com (832-969-8881)
VETERINARY INFORMATION RELEASE FORM
To be filled out by veterinary office
To Whom It May Concern:
Name of Adopter
has applied to adopt a cat/ kitten from Dori's Darlings Cat Rescue. We
would like to obtain a reference to ensure that we are making an appropriate placement. We would appreciate your
time in assisting us, by filling out this reference form.
Dr.
Clinic/ Hospital Address:
Phone: ____________________________________________FX: ___________________________________________
How long has this person been a client?
How many pets (total) have been under your care?
How many are currently under your care?
Names?
Indoor?
Outdoor
Both?
Have any cats, past or present, been declawed?
Were they declawed at your clinic?
Date of surgery(ies)
Have all pets been spayed or neutered?
Up to date on vaccinations?
Are pets on heartworm preventative?
Have cats been tested for FIV & FELV
Results? FIV
FELV
Is there any reason you would or would not recommend placement of a cat/ kitten with this client?
Other comments:
Name and Signature of Person Completing this form
Date:
All information is confidential
THANK YOU FOR YOUR ASSISTANCE
Please email completed forms to doris.darlings@gmail.com or fax to 281-469-3696
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