Name:

Address:

City/State:

Home Phone: Work Phone:

Do you rent or own your home?Rent Own

(If you rent, please list the name and phone number of your apartment complex, mobile home park, condo association or management office. We must obtain your landlord's approval before an adoption can take place.)

Name: Phone:

Most leases require some type of pet deposit or signed agreement before the pet can move into the residence. If your landlord has size weight restrictions on pets, you must follow these guidelines.

Reason for adopting a pet?


Will your new pet be kept outside?YesNo
If yes, do you have a fence?YesNo
Do you have pets in your home now?YesNo

All pets threes months and older must be vaccinated and licensed for rabies. We also encourage pet owners to have their other pets spayed or neutered.

Please list the names and the ages of all pets at your residence:


Please give us the name of the veterinary clinic(s) which administered the vaccinations to your pet(s). We must confirm current rabies vaccinations and licensing before you will be allowed to adopt.


Is everyone in your household aware of your intention to adopt a pet?YesNo
Is anyone in your household allergic to animals?YesNo

Please list all pets that you have owned over the past five years and their current status (still owned, deceased, etc.)


Although Animal Services has provided a medical exam and some veterinary services for you new pet, your pet will need additional care. Are you prepared to provide your new pet with all necessary vet care?YesNo

Who will be primarily responsible for the care of your new pet?


Have you ever received a citation from Animal Services, been convicted of cruelty to animals or had an animal impounded by our facility?YesNo

Please Note:

You will need to visit Animal Services and sign a form certifying that the information submitted is true and correct to the best of your knowledge. A valid ID (driver's license, Florida ID card) is required to complete an adoption.