Vincennes Animal Shelter READY TO ADOPT? START HERE Phone 812-882-8826
1128 South River Road Fax 812-255-5247
Vincennes, IN 47591 Email
Date______Your Adoption Counselor is______
Name of Animal______
This questionnaire must be completed by anyone interested in adopting a pet from the Vincennes Animal Shelter. We want to place our animals in permanent, responsible homes and at the same time match you with a pet that is suitable for your family and your friends.
First Name______
Last Name______
Date of birth ______
Current Address______City______State______Zip______
Home Phone ______Work Phone______
Cell Phone______
Email Address is a Shelter Care Pet Insurance requirement. You MUST enroll online within 72 hours to activate insurance:
PLEASE PRINT EMAIL ADDRESS______
1. What type of pet are you looking for? Dog______Puppy______Cat______Kitten______Other______
2. Place of Employment______
3. Are you 18 years or older? _____ Are you a student? ______
4. What are the ages of the children in your household? ______
5. Has any animal died on your premises of distemper, parvo or unknown causes within the last three (3) months? ______
6. Do you or anyone in the household have pets? ______
7. What is the name of your veterinarian or vet clinic? ______
VINCENNES AMIMAL SHELTER 1128 RIVER ROAD 812-882-8826
PLEASE SHARE PICTRUES OF YOUR NEW PET ON OUR FACEBOOK PAGE VINCENNES ANIMAL SHELTER AND AS ALWAYS VISIT OUR WEB SITE VINCENNES.ORG (CLICK ON ANIMAL CONTROL)
Animal, Health Insurance & Personal Information Disclosure
Vincennes Animal Shelter
The Vincennes Animal Shelter reserves the right to refuse adoption to anyone. No animal will be adopted to persons having an extensive history of losing, giving away, selling, or having animals injured or killed by moving vehicles. No animal will be adopted to prospective owners who mislead or fail to provide accurate information on the adoption application.
1. The animals available for adoption came here from a variety of sources, and histories are not available on most of these animals. All animals are examined upon entry, and their health is routinely monitored while at the shelter, however there is always the chance that an animal is incubating a disease without showing any clinical signs. Therefore your veterinarian should examine any new pet within 5 business days of adoption, (and proper medical care should be provided for the remainder of its life.
2. I understand that the adoption fee is considered a donation, there will be NO refunds unless it is determined by a veterinarian, within 5 business days after the animal leaves Vincennes Animal Shelter, that the animal is ill and that you wish to return it to the Vincennes Animal Shelter at that time. Return of your adoption fee will NOT be immediate. A check will be mailed to the address on this application within 3 weeks of the return of the animal. The fee will never be refunded in cash, even if paid in cash. Refunds will NOT be given if you decide that the animal isn’t suitable for your home, or any other non-medical reason. The Vincennes Animal Shelter will accept the return of any pet adopted from our facility at any time if you can no longer keep it. Please call ahead and make an appointment if you must relinquish your pet.
3. All animals adopted from the Vincennes Animal Shelter will be altered (spayed or neutered) prior to going home with their new family. You will be expected to take your new pet to your veterinarian within 5 business days for any additional vaccinations or tests that may be needed. Many veterinarians will do a free examination when you present your adoption paperwork. (Please remember to make an appointment and inquire if there will be an office visit charges.) All additional tests, medications or vaccinations are NOT included in the free exam. (SOUTHGATE VET or VINCENNES VET will grant you a courtesy well visit exam within 5 days of adoption)
4. I understand that I must enroll via e-mail within 72 hours of adoption to activate Shelter Care Pet Insurance.
Please initial on line
______A staff member had explained heartworms, how dogs get heartworms and how they are prevented.
______A staff member has explained my dog\cat may need a booster vaccine within 5 days to one year.
______A staff member has explained to me that my dog\cat may need a rabies shot within five days.
______A staff member has explained to me that my dog must wear a currant rabies tag and currant Vincennes animal control tags.
______A staff member has explained to me that if my dog is lost I should call Vincennes animal control and report it.
______A staff member has explained to me that this dog or cat can be returned to Vincennes animal shelter at any time (with not refund) if the animal does not work out .
I have read and agree to all the above conditions.
(Signature) X______Date______