This Pre Adoption Information will help us evaluate your adoption eligibility for a pet. This
questionnaire will be kept in our files and is the property of the Cass River Pet FriendZ. Please
feel free to ask any questions before completing this form.
Name_________________________________Phone____________________ County___________________
Address_______________________________
City____________________ State____ Zip__________
1.Name of the pet you are interested in adopting OR what type/breed of pet you are looking for:
Name____________________________OR type/breed________________________
Sex : No preference_____Male_____Female_____
Size Small (under 12 inches)____ Medium (12 17 inches)_____Large (18 inches or taller)____
2. Where will the pet stay? Inside the house _____ Outside the house_____
3. Is the pet for you? _____If not, who is the pet for?__________________
4. Do you have a fenced yard?______
5. Do you live in a: House____ Apartment____ Mobile Home____ Other, where________
6. Do you own or rent your home? Own ______ Rent______
7. If you are renting, please give us the name and phone number of the property owner
Name __________________________Phone________________
8. Do you have children living in your home? _______What are their ages?________________________
9. Do you have any pets now?___________ If yes, what are they and how many do you have?
___________________________________________________________________________________
Are they spayed or neutered?________
10. Have you adopted an animal from a Shelter or Rescue Group before?________If yes, do you still
have this pet?________ If no, what happened to this pet?__________________________________
11. Are you financially able to provide this new pet with proper food and medical care?________
12. Does your family/spouse know that this new pet is coming into their home?________
13. Do you work long hours away from home?________
14. Do you travel a lot?________ If yes, would your new pet travel with you?_________
15. What kind of arrangements would you make for your pet while you work and/or travel?_________________
___________________________________________________________________________________
16. Who is your veterinarian? Name_______________________Phone #___________________________
Address: City___________________________ State___________________
17. Reference (non family)
Name____________________________Address__________________________________________
City____________________________State_____ZIP________ Phone____________________
Relationship to you________________________
Follow up
Cass River Pet FriendZ RepresentativeDate_____________________________________
CRPF #________
Notes_____________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
___________________________________________________________________________________________
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