Pre-Adoption Form Pre-Adoption Form Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email*(By providing this information, you may receive communications from Northeast Animal Shelter) Phone*Do you own or rent your home?*OwnRentIf you answered 'rent,' please provide your landlord's name and phone number.*How long have you been at this address?*Are you planning to move?*YesNoWhen do you plan to move?Does your lease allow pets?*Yes, cats onlyYes, cats and dogsNoAre there other pet restrictions under your lease?* Certain breeds not allowed Large dogs not allowed Landlord's approval required How would you describe your home?*Single-family houseMulti-family houseApartmentCondo/Town houseWhat is your household activity level?*Quiet as a libraryGrand Central StationSomewhere in betweenWhat is your experience as a pet owner?*First-time ownerHave had 1 or 2Knowledgeable and experiencedWhat children will be at home?*NoneSometimes children visit1 or more children under 13Children & TeenagersTeenagers, but no young childrenList all people who will be living with the new pet*Please list names, ages, and relationshipsWho will the new pet be for?*Myself onlyMy familyWho will be the primary caregiver?*MyselfMy familyIs anyone in your home allergic to cats or dogs?*Yes, cats onlyYes, dogs onlyYes, cats and dogsNoTell us about your typical day*Please let us know if you expect the pet will be home alone for more than a few hoursTell us about a typical day for others in your household*References & Alternate Contacts*Please list two people who could be used as references and/or contacts in case of emergency. Include name, city, state, and phone number.What kind of pet are you thinking about adopting?* Kitten Cat Puppy Dog Please tell us in as much detail as possible what you are looking for. Do you have a preference of male vs. female? What kind of temperament/personality characteristics are you looking for? What about physical characteristics? For canines for example, what full-grown size range or coat would work for you? For felines, do you prefer short or long-haired?If you are looking for a kitten or cat, will it be declawed?*YesNoWill the pet be allowed outside by itself?*YesNoWhere will the pet be when outside by itself?*In a fenced yardIn a penIn a crateTied upOn a runnerAllowed to roam outside the yardHow many hours at a time will the puppy/dog be left alone outside?*When inside, the puppy/dog will be:*in a cratein limited room(s)free to roam the houseTell us about other pets you have ownedPlease indicate if you still own the pet, name, cat or dog, age, breed, spayed or neutered, current with vaccines, and if no longer owned, what happened?