Pet Adoption Pre-Screening Questionnaire

Full Name Email Address Phone Number Address

Which pet are you interested in adopting? Type of Home House Apartment Condo Other Do you own or rent your home? Own Rent If you rent, does your landlord allow pets? Yes No Not Applicable

Please list all household members and their ages. List any pets currently living in your home. Does anyone in your home have allergies to animals? Yes No

How many hours per day will the pet be left alone? Please describe your experience with pets. Why do you want to adopt a pet?

Who will be primarily responsible for the pet's care? Are you prepared for veterinary care and other expenses? Yes No Is there anything else you'd like us to know?