Austin Veterinary Diagnostic Hospital

9324 C Hwy 290W.

Austin, TX. 78736

(512) 288-1040

Adoption Agreement

This agreement is made between AVDH and the adopter. By signing below, you are acknowledging receipt from AVDH and the pet described within the application. An adopter must be 18 years of age or older and agree to be bound by and comply with the following terms and conditions:

Adopter agrees:

·  To provide year round Heartworm/Flea preventative.

·  To provide annual wellness check ups.

·  To pay an adoption fee. This includes the cost of initial vaccinations, spay/neuter and microchip.

Adoption Policy:

It is our goal to match dedicated owners to deserving pets. Therefore, we allow a three day trial period. If pet is not returned within the trial period, the adopter takes full ownership and responsibility for the pet. This strict policy allows us to keep space available to rescue another special pet.

Adoption Cost:

AVDH acknowledges receipt of total fee in the amount of $150.00 from the Adopter.

Copies of receipts specifically allocable to this dog are attached and accounted for.

Adopter agrees that AVDH is not responsible for any medical expenses after adoption transfer.

I UNDERSTAND THAT AFTER 3 DAYS PETS MAY NOT BE RETURNED TO

“WAGS 2 RICHES” ______(INTIALS). IF PET DOES NOT WORK OUT, IT IS THE ADOPTER’S RESPONSIBILITY TO FIND A NEW ADOPTIVE PARENT/FAMILY.

Medical Tests and Procedures:

AVDH represents that the dog has had vaccinations and heartworm tests on the dates below:

Vaccinations/Tests Date Performed
Rabies Vx.
Lymes Vx.
Fd6 Vx.
Heartworm Test
Spay/Neuter (Circle One)

Adopter Information:

Name: Last:______First:______

Address: ______City:______State:_____Zip:______

Phone: Hm:______Cell:______Wk:______

Email: Primary:______Secondary:______

Pet Information:

Name of Pet: ______Approximate Age:______

Male or Female:______Color:______

Breed:______Altered: Yes______or No______

Method of Payment:

Total Payment Collected: $______Cash______Check______#______C/C______

This agreement is between Austin Veterinary Diagnostic Hospital and the Adopter.

Adopter hereby takes possession and acknowledges receipt of pet under the following terms and conditions.

I, ______, the Adopter, have read and understand the terms of this agreement, executed this ______day of______year______.

Adopter Signature______Date______

Adoption Coordinator Signature______Date ______