Pet Adoption Which animal are you interested in adopting? Name(required) Contact Name(required) Occupation Address (City, State, ZIP)(required) How long have you been at this address?(required) Phone Number (Day)(required) Phone Number (Night)(required) When is the best time to call? Email Family & Housing How many adults are in your family (and what is their relationship to you)?(required) How many children are in your family (age)?(required) What type of home do you have (single family, townhouse, apartment, farm, etc.)?(required) What best describes your household?(required) Active Noisy Quiet Average If you rent, please give the rules governing pets with the landlord's name and number Does anyone in your home have a known allergy to animals?(required) Yes No If so, what allergy? Is everyone in agreement with the decision to adopt a pet?(required) Yes No Do you have time to provide adequate love and attention?(required) Yes No Other Pets What other pets do you have (type and number)?(required) Are your pets up-to-date on vaccines? Yes No Are your pets spayed/neutered? If not, why? Have you ever had a pet euthanized? If so, why?(required) Have you lost a pet to an accident?(required) Yes No How do you discipline your pets and why?(required) Veterinarian Do you have a regular veterinarian?(required) Yes No Name Clinic Address Phone Number By providing King Vet Clinic with this information, you are allowing us to call your vet. Please, call your vet and ask them to authorize the release of information to our clinic. About the Pet to Adopt Sex No Preference Male Female Where would the pet spend the day?(required) Where would the pet spend the night?(required) How many hours will the pet be alone on average?(required) Who will have financial responsibility for the pet?(required) Do you agree to provide regular health care by a licensed veterinarian?(required) Yes No How do you plan to supervise the pet when it's outside?(required) References Please list two people who are familiar with you and your pets. Reference 1 (name, address, phone, relationship)(required) Reference 2 (name, address, phone, relationship)(required) All of the information I have given is true and complete. This animal will reside in my home as a pet. I will provide it with quality food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed veterinarian. I also agree to have the animal spayed or neutered prior to 1 year of age if the dog is not already altered. Full Name(required) Submit Δ
King Veterinary Clinic 