148 S. Dowlen Rd. #682
Beaumont, TX 77707
PetsInTransition,Inc.ADOPTIONAPPLICATION
Ourgoalistoplacepetsinpermanent,lovinghomes. Pleasecompletethisapplicationandcontractsowe(P.I.T.)canassistyouinfindingaspecial,compatiblecompaniontojoinyourfamily. Withthisinformation,we(P.I.T.)minimizetheriskofafailedadoption. Wedonotadoptdogsorcatsona “firstcome,firstserved” basis,butrathermakeeveryattempttomatchfamilieswiththemostcompatiblepets. Wereservetherighttodeclineanyapplication. Theadoptionfeefordogsis$150. Theadoptionfeeforcatsis$85. Thesefeeshelptodefraythecostsofspaying/neutering,testingandvaccinatingourpets,butrarelycoverallexpenses. Ourdogsareheartwormtestedandplacedonheartwormpreventative. Ifthedogisheartwormpositive,Heartgard®istheonlypreventativeortreatmentthatmaybeadministered. Anyothertypeofheartwormpreventativeortreatmentcouldcausethedogtobecomeseriouslyillorevendie.
Pleaseprintclearly. (Mustbeatleast21yearsofagetoadopt).
NAME:
Nameofanimalinwhichyouareinterested: Date:
Breed/Description:Male/Female
ReleaseforVeterinaryReference:(tobecompletedbypotentialadopter)
I, ,herebygivepermissionforanyveterinarianprovidingservicetometoreleasemedicalinformationonany/allofmyanimalstoPetsInTransition,Inc.
(signature)
Mycurrentveterinarianis
locatedatandcanbereachedat( )
Driver’sLicense# DateofBirth: Email:
Address(includeCityandZipCode)
Homephone( )Workphone( )Cellphone( )
EmployerWhatareyourhours?
Spouse/PartnerEmployer Workorcellphone()
Howlongwouldthepetbeleftalone? Wherewouldthepetstay?
Doyouoryourspouse/partnertravelfrequently?Ifso,howoften?
Whatwillyoudowiththepetwhenyoutravel?
Whatwillyoudowiththispetifyouhavetomove?
Areyouwilling/abletopurchaseanduseacrateifneededoradvised?
Doyouhaveapetdoor? Howwouldyouhandlethedog’s/cat’spottyneeds?
Haveyouhousetrainedananimalbefore? Ifso,describehowyouaccomplishedthis
Howwouldyouexercisethepet?
Wherewouldthepetsleep?
Doyoulivealoneorwithfamily? Doeseveryadultinthehouseholdagreeonowningthispet?
Doesanyoneinthehouseholdhaveallergies? Ifso,aretheyallergictoanimaldander?
Doyouhavechildren/grandchildren? Whatages?
Dotheyliveinthehousehold? Iftheydonotlivewithyou,howoftendotheyvisit?
Areyouwillingandabletocommittobehaviorand/ordogobediencetraining?
Doyouownorrent? Houseorapartment? Ifrenting,howlongatthislocation?
Ifrenting,doesyourleaseallowpets? Breedorweightrestrictions?
Petdeposit?(Wewillneedconfirmationofpaymentofanyrequiredpetdeposit.)
Rentalmanager’snameandphonenumber
Doyouhaveafencedyard?Whattypeoffenceandhowhigh?
Doyouhaveapool? Ifso,istheareafencedoff?
Haveyouownedthisbreed/mixbefore? Haveyouownedarescuedanimalbefore?
Haveyoueveradoptedfromarescuegrouporshelter? Ifso,whatgroup/shelter?
Haveyouappliedtoadoptananimalandbeendeclined?Ifso,why
Haveyouevergivenupanimal(s)? Ifso,why?
Whatdidyoudowiththeanimal(s)?
Whatqualitiesareyoulookingforinapet? (Pleasebespecific)
WhattraitsorcharacteristicsareyousureyoudoNOTwant?
DoyougivepermissionforaP.I.T.representativetovisityourhomepriortoadoptiontodoahomecheckandafteradoptiontodofollowupchecksonthepet?
PETOWNERSHIPHISTORY
Doyouordidyouhaveotherpets? Pleasestatethebreed,sex,etc.ofeachpet,includingwhetheritwasspayedorneuteredandonheartwormpreventive,andhowandwhenthepetwasacquiredandwhyyounolongerhavetheanimal. Ifnecessary,attachanothersheetorwriteontheback.
NameDogorcat? Howacquired?
BreedMaleorFemale? Spayed/neutered?
AgeofpetLengthofownership
Heartwormpreventative? WhatkindofHeartwormpreventative?Whenlastgiven?
Dateoflastshots:DHLPPBordetellaRabies
Wheredidthisanimalsleep?
Wheredidthepetstaywhileyouwereawayoratwork?
Didthispethaveanyproblemsorconditions?
Whathappenedtothispet?
NameDogorcat? Howacquired?
BreedMaleorFemale? Spayed/neutered?
AgeofpetLengthofownership
Heartwormpreventative? WhatkindofHeartwormpreventative?Whenlastgiven?
Dateoflastshots:DHLPPBordetellaRabies
Wheredidthisanimalsleep?
Wheredidthepetstaywhileyouwereawayoratwork?
Didthispethaveanyproblemsorconditions?
Whathappenedtothispet?
1.IagreemyadoptionfeeisNON-REFUNDABLEevenifthepetisreturnedtoPetsInTransition.(P.I.T.)
2.IagreethatIwillneversell,trade,orgiveawaythispettoanyone. Iwillneverrelinquishthispettoanyshelterorpound,whether “no-kill” orotherwise. IwillnotifyP.I.T.ifIamunableorunwillingtokeepthispet,andIwillreturnthispettoP.I.Tafterarrangementshavebeenmadeforsuchreturn. Iwillkeeptagsonthedogwithcurrentinformationatalltimes.
____ 3.Iagreethatallfuturemedicalandhealthmaintenancetreatmentsaremyresponsibility,unlessP.I.T.hasspecificallyagreedtopayforthemunderthe “specialprovisions” attheendofthiscontract. Iwilladministermonthlyheartwormpreventativetothedogyearround. Ifthedogisheartwormpositive,IunderstandthatHeartgard®istheonlypreventative/treatmentthatmaybeadministered. Anyothertypeofheartwormtreatmentorpreventativecouldcausethedogtobecomeseriouslyillorevendie.
4.Mydogwillbeprimarilyindoors,interactingwithmyfamily,andwillnottobebanishedtothebackyard. Iwillnevertiemydogtoachainorropeorleavehim/herunattendedforlongperiods.
5.Iwillprotectthispetwithannualvaccinationsandroutinemedicalcareandhealthmaintenanceasrecommendedbymyveterinarian. Iwillseekimmediate(attimeofinjuryorsignsofillness)veterinarycareifthispetbecomesillorisinjured. Iunderstandthisisforthelifetimeofthepet.
6.IagreethatthepetSHALLNOTbephysicallyalteredinanymanner(dockingtails,croppingears,declawing,etc.).
7.Iwillcomplywithallstateandlocalordinancesintheconfinement,care,andlicensingofthispet. Iwillreclaimthispetpromptly,andpayanyrequiredfeesifitispickedupbyananimalcontrolagency. RabiesandIDtagswillbekeptontheanimalatalltimes. Catswillonlywearabreakawaycollarspecificallydesignedforcats.
8.IunderstandthatP.I.T.doesnotmakeanyguaranteesregardingtheage,nature,temperament,orhealthofthispet. Iassumeallriskandresponsibilityofownershipofthispetoncehe/sheisinmypossession. Iagreetodefend,indemnify,andholdharmlessP.I.T.anditsagentsagainstanyandallclaimsincludingclaimsofpropertydamageand/orpersonalinjury,whicharisefrommyadoptionofthispet.
9.IfIfailtofullyandtimelycomplywiththetermsofthiscontract,Iwill,voluntarily,immediatelyreleaseownership,possession,custodyandcontrolofthispettoP.I.T.,andifIfailtodoso,P.I.T.willbeentitledtoenforcespecificperformanceofthiscontractinadditiontoanyotherlegalremedyavailabletoP.I.T.
10.IaffirmthatallinformationintheApplicationistrue,completeandcorrectandagreethatanyfalseormisleadingstatementthereonwillconstituteabreachofthiscontract.
11. Specialprovisionsofthiscontract,ifany,areasfollows: ______
MysignaturebelowaffirmsthatIhavereadandagreetoalltheaboveconditions:
SignatureDate
Please email this completed application to:
You may also mail a completed copy to:
Pets In Transition, Inc.
148 S. Dowlen Rd. #682
Beaumont, TX 77707