Lake Haven Online Pet Adoption Application
Online Application Instructions: Please fill out the application below. Only those applic
ations that are completely filled out are able to be processed. If you would like to see the terms of the application again, please click here.
Application Intent
What are your intentions for filling out this application?
I would like to MEET a pet for potential adoption
I have already met my pet of choice and am READY TO COMMIT Name of pet you are interested in adopting:
Contact Information
Please provide the following contact information:
City:
Email Address:
Alternate Email Address:
(note: Please double check your email address for
accuracy. We will use this address to reply to you. If you mistype the
address, you will not receive our reply. Please, only one email per line.)
Housing Accommodations
Do you own your current home?
Condo
Mobile
home
IF RENTING, please describe any restrictions on pets...
size, breed, (declawed) cats, etc.
First Name: Last Name:
Yes
No
House
Apartment
How long have you been renting? (approximate years, months).
Employment Information
Are
YOU currently employed?
Yes
No
IF YES, list your current employer and how many years
you have been employed.
If there is another adult head of household, is
that person currently employed?
Yes
No
IF YES, list current employer and how many years
they have been employed.
Pet Accommodations
Where will your new pet stay when you are away?
How many hours a day
do you anticipate your pet being home alone?
Where will your new
pet sleep at night?
If you are applying for a DOG or PUPPY:
How will the dog be let out to relieve itself? (Select all that apply)
Fenced yard
Leash walk
Free roam
Tie out cable
Kennel run
Loose with supervision
Other
(please explain below)
IF "OTHER" above, please explain.
Are you familiar with crate training?
Yes
No
Do you intend to use a crate?
Yes
No
Do you currently have a crate?
Yes
No
If you are applying for a CAT, will the cat be allowed outdoors?
Overnight
As it wishes
Current/Previous Pets
Please list all pets
currently living in your home. Include name, breed, age, and how long you
have had them.
Please list all pets
you have previously owned. Include name, breed, and why you no longer have
them.
Are
your current pets spayed/neutered?
Yes
No
Are
your present pets current on vaccinations?
Yes
No
If
you currently have dogs, have they been heartworm tested?
Yes
No
If
you currently have dogs, are they on heartworm prevention?
Yes
No
If your answer to the previous questions for any of your current pets was "No", please explain.
Veterinarian Information
Please provide the following veterinarian information. (REQUIRED: Make sure you have contacted your current vet and requested a "release of information" to Lake Haven before submitting this application. This authorizes your vet to talk to us. We are unable to process applications without speaking to your current or most recent vet.)
Hospital/Clinic Name:
Street Address:
City:
State: Zip:Phone: Fax:
If you have
used any other veterinarian, please list names and phone numbers below.
Include which pets they treated.
Additional Considerations
Please share
additional comments or considerations that you would like us to know:
Lake Haven Website
How did you hear about Lake
Haven's website? (select all that apply)
Lake
Haven volunteer
At
PetSmart
Attending
Saturday Adoption Day (at
PetSmart)
PetFinder.com
Craigslist.com
General
Internet search
Other
IF "OTHER" above, please explain.
Please review your application now before you submit. Please only click the submit button once.