Parrots & Paws Pets Are Us Rescue Kim parrotsandpaws@yahoo.com Animal Adoption Form Date: _______________ How did you hear of us: _________________________________________________________ Full Name:___________________________________________________________________ Address:_____________________________________________________________________ City, State, Zip:________________________________________________________________ Email:_______________________________________________________________________ Phone Number:________________________________________________________________ Work Phone Number:___________________________________________________________ Cell Number:__________________________________________________________________ Fax Number:__________________________________________________________________ Name of current vet.:____________________________________________________________ Address of vet:_________________________________________________________________ Phone Number of vet:___________________________________________________________ Personal Reference:_____________________________________________________________ Phone Number of Reference:______________________________________________________ Animal to be Adopted:___________________________________________________________ Age of Animal:________________________________________________________________ Gender and type of Animal:_______________________________________________________ What is your opinion of adoptive animal:_____________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ________________________________________________________________________ How many hours a day will animal be left alone:_______________________________________ Where will the animal be housed when alone:_________________________________________ ____________________________________________________________________________ What type of food will be fed:_____________________________________________________ Do you own any other animals:____________________________________________________ Ages, Sex, Type of these animals:__________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Are all pets up to date on vaccines and heartworm preventive:_____________________________ ____________________________________________________________________________ Are your pets spayed or neutered:__________________________________________________ Have you ever owned this type of adoptive animal before:________________________________ If so what happened to it:_________________________________________________________ ______________________________________________________________________________ __________________________________________________________________________ Have any previous animals died due to disease:________________________________________ ____________________________________________________________________________ Do you have children:___________________________________________________________ Ages of Children:_______________________________________________________________ What type of household do you live in(apt, house, duplex, etc.):____________________________ ____________________________________________________________________________ Do you have a fenced yard:_______________________________________________________ Why do you feel you would be a good adoptive parent to this animal:_______________________ ____________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _________________________________________________________________ Please Read Carefully This form is evaluated by Parrots & Paws div. Of Pets Are Us Rescue.  Our goal is to place this animal in the best home we feel possible. By signing this you agree for our rescue org. to check on the conditions and living circumstances as we choose. All adoptive pets are not to be bred or resold! If for some reason the animal does not work out in your home the animal is to be returned to our rescue org. so we may find another suitable home. Adoption fees are a non- refundable donation. Parrots & Paws div. of Pets Are Us Rescue is a non-profit org. and all fees collected are used to care for the animals in our care and the future animals soon to be in our care. We survive solely on these donations and mostly the use of our own money for animal care. There is no health guarantee on any animal adopted. Our promise to you is that we will never knowingly adopt an ill or diseased animal. We try to find out all past information an the animal but after all these are rescue animals and their past may be a mystery. We do our best to ensure good health by providing the animal with current vaccines, worming, rabies (if old enough), and altering. Some animals may be adopted without being altered, it is then the responsibility of the new adoptive parents to have this done. If an animal is not altered at the time of adoption then proof can be returned to Parrots & Paws and a refund of $25.00 will be returned. Please read carefully and understand all conditions associated with this adoption application . Signature:________________________________ Date:_____________________________