Please!!! Don't Abuse The Animals

About Author
Missy's Story
Digby's Story
Joey's Story
Morkey's Story
Snow Ball's Story
Mid Night's Story
Frosty's Story
Cuddle's Story
Fluffy's Story
Pet Memorial
Types of Abuse
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Questionnaire
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Questionnaire

Pet Information:

Name of Pet:____________________

Canine: Feline: Other: Breed: ____________________

Estimated Age:________ Spay/Neutered: Yes No

Vaccinations: Yes No Felines: Canines:
Leukemia Distemper Rabies DHLP-Par
FVRCP Corona
FIP Bordatella
Deworm
Rabies

Applicant Information:

Name:____________________

Address: ____________________

Home Phone:____________________

City: ____________________

State:____________________

ZIP:____________________

Work Phone: ____________________

Driver?s License:____________________

State:____________________

Car License:____________________

1. Do you live in a House: Condo: Apartment: Other:

(Please Specify)  ____________________

2. How long have you lived there?  ____________________

3. Do you rent? Yes No

If yes, do you have permission from your landlord to have a pet? Yes No

May we contact you landlord? Yes No

Name: ____________________

Phone: ____________________

4. Are you aware that pets need regular vaccinations and may require routine veterinary care? Yes No

5. Are you willing to provide adequate veterinary care if this animal becomes sick or injured? Yes No

6. Name of veterinarian: ____________________

Phone: ____________________

7. Would you object to an inspection of your premises by our personnel? Yes No

8. Do you plan to put an I.D. tag on this pet? Yes No

9. Do you plan to spay/neuter this pet? Yes No

If not, please explain why ____________________

10. How many hours per day will the pet be left alone?

Where will the pet be kept during this time?  ____________________

Will the pet be kept: Indoors Outdoors Both

11. Is anyone in your home allergic to animals? Yes No Don?t Know

12. What other pets do you currently own?

# of dogs:______ # of cats:______

# of others (please specify) ______

Please furnish breeds, sex and ages of all pets:  ____________________

13. Please list the ages of children in the home.  ____________________

14. On the first night in the home, where will the pet stay?

(please specify) ____________________

15. Who will be responsible for the pet?  ____________________

16. Have you ever owned a pet before? Yes No

If yes, what happened to the pet?  ____________________

If deceased, please state cause if know, and how long ago?

_______________________________________________________________

_______________________________________________________________

17. Pets have been know to chew/claw furniture, carpets and drapes and dig in the potted plants, etc. ? how do you plan to deal with this problem?

_______________________________________________________________

_______________________________________________________________

18. If you are adopting a dog, are you planning to take it to an obedience class in your area? Yes No

19. How soon after the pet arrives in your home will it be left alone?  ____________________________________________________

20. How often do you travel? ____________________

How will the pet be cared for when you are out of town? ____________________

21. What will happen to the pet if you move (locally)?  ____________________

Out of state? ____________________

Overseas? ____________________

22. Under what circumstances would you not keep the pet?

Divorce ___   Move ___   New Baby ___   New Job ___   Illness ___

Other (please explain) ____________________

 
 

[ About Author | Missy's Story | Digby's Story | Joey's Story ]

[ Morkey's Story | Snow Ball's Story | Mid Night's Story | Frosty's Story ]
[ Fluffy's Story | Cuddles Story | Lucky's Story | Pet Memorial ]
[ Types of Abuse | Prevention | Rights & Welfare | Spay & Neuter ]

[ Questionnaire | Puppy Mills | Cat Care | Dog Care | Dog Training ]

[ Pests to Pets | Charities | Moments in Life | Web Site Journal ]

[ Favorite Links | Link to Me! | Legal Info | Contact Me! | GuestBook ]

[ Site Map | Home | Awards Won | Awards Program ]

 

All Material is Written by Anita Eberline
No part may be reproduced without prior permission by Anita Eberline.


ICRA