Luna's
House, Inc. Adoption Application
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If you
are considering adopting a pet from Luna's House, please take
the time to fill out this application. By filling out the application
you allow us to match the perfect pet for your household. Filling
out the application is not a commitment to adopt.
**You
MUST fill out this application completely. Partially filled out
applications will NOT be accepted**
If
for some reason you have technical problems with this
form, please let us know
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Name
of animal you are interested
in (if applicable): |
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| Your
name |
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| Address
(incl city&zip): |
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| Telephone: |
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| Email address
(PLEASE BE ACCURATE, this is how
we will contact you): |
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| What type
of home do you have? |
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| Do you
(select all that apply) |
Own
Rent living w/roommates
Rent living alone
Living with Parents
Student
Other
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| If
renting, Landlord's Name and Phone |
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| How
long have you been at your current address? |
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| Is
everyone in the household aware of your decision to adopt an
animal? |
Yes
No |
| If
not, list their name(s) |
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| Does any
member of your household have any known allergies to animals? |
Yes
No |
| If yes,
please describe: |
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| Are
you at least 18 years of age? |
Yes
No |
| What
is your experience with the type of animal before? |
Have never been the guardian for this type of animal before
Have had 1-2
Have had several |
| Have you
adopted from Luna's House, Inc. in the past? |
Yes
No |
| If
yes, do you still have the pet? |
Yes
No |
| If you
no longer have your pet please explain why?: |
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| Please
state your reason for wanting to add the animal you wish to
adopt to your household |
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| Where
will the animal you adopt be residing? |
Inside
Outside
Both |
| Please
describe where you intend to keep your new pet and the type/size
of cage you will use (Suitable housing can be recommended): |
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| Who
will take primary responsibility for the animal you wish to
adopt? |
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| Do you
know how to introduce the new animal to other animals living
in your home? |
Yes
No |
| Are
you willing to work through any unforeseen behavioral problems
you may encounter with your new animal? |
Yes
No |
| If
no, why not? |
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| Have you
ever surrendered an animal to a shelter? |
Yes
No |
| If yes,
what were the circumstances? |
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| Please
describe (include all animals including housemates' animals),
type, age, sex, spayed/neutered? where kept? Had how long? |
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| Are
your pet's vaccinations and medical examinations up-to-date? |
Yes
No |
What vet
hospital(s) do you/will you use?
(An experienced veterinarian for the type of animal you are adopting can
be recommended)
|
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| Do
you agree that you will see a veterinarian within 7-10 days
of adoption? |
Yes
No |
For Rabbits
and Guinea Pigs
Do you understand that this animal may have been exposed to URI (upper
respiratory infection) or coccidia and may show signs once you
get the animal home?
|
Yes
No |
| If your
pet does show signs of URI or coccidia, do you agree that you
will have the pet treated by a veterinarian at your expense? |
Yes
No |
Do you
understand why you need to get this small animal spayed/neutered
(if applicable)?
(All
rabbits must be spayed/neutered)
|
Yes
No |
| Please click submit when you are done: |
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