Adoption procedures include: a pre-adoption questionnaire, an adoption agreement, and an adoption fee. Fees include the animal's vet check, spay/neuter, shots, worming, heartworm testing, feline leukemia testing, and any other medical expense. We do require a personal visit from you to our shelter. We do not transport. Please complete the questionnaire below. You will receive a prompt response; if you do not, please email us directly at clintoncohumanesociety@yahoo.com.

Animal Name:
Your full name:
Age of adopter:
Street address:
City:
State:
ZIP:
Primary phone:
Email address:
Do you rent or own?	Rent Own
How long have you lived at this address?
If you rent, does your lease allow pets?	Yes No Not applicable
How many pets are allowed on lease?
Do you live in a house, condo, apartment, mobile home?
Is your yard fenced, and what is the approximate size?
Do you currently own other pets?	Yes No
Please list breed, gender, and age of current pets:
Have you previously owned pets?	Yes No
What breed/types have you owned in the past?
How long did you have the pet(s), and where are they now?
Are your pets spayed and/or neutered? If not, why not?
Are your current dogs licensed? If not, why not?
Are your pets current on vaccinations? If not, why not?
Have you ever taken a pet to the pound? If yes, please explain.
If you have children in your household what are their ages and relationship to you.
Is anyone in your household allergic to animals? If so, whom and to what type of pet?
Why are you interested in this pet?
Is this pet a gift for someone? If so, whom?
What is your preferred level of exercise for a dog?	Couch potato Yard exercise Short walks Vigorous walks Hiking/jogging
Where will the animal be kept?
When inside, how do you plan to keep your pet? Check all that apply.	Free inside house Confined to a crate Inside a closed room
When outside, how do you plan to keep your pet? Check all that apply.	Not applicable; indoors only Tie-out chain Garage Patio area Invisible fence Fenced yard Outside dog run Leash and regular walks Loose in yard, unattended
Who will be responsible for medical and/or training costs?
Current or past veterinary facility and its phone number:
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Comments or Questions?

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