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Home Adopt A Pet Support/Volunteer News And Events
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years or older
Date: DL # (Must provide a copy to FFR):
Name:
Address:
City:
State: Zip Code:
Home Phone Number: Work Phone Number:
Cell Phone Number: Best Time to Call
Email address:
Occupation:
Spouse's occupation (if applicable)
Check all that apply: Student
Employed
Retired
Family Members/Guests With You Today
Description of Residence:
Do you live with parents?YesNo
Do you live with a non-relative?YesNo
If you rent:
Number of people in household: Adults: Children:
Does anyone living in the household have allergies to:
Does anyone living in the household have asthma? YesNo
Are you willing to let a representative of Fuzzy Friends Rescue visit your home by appointment?YesNo
Who will support this cat financially?:
Does your house have:
Why do you want to get a cat/kitten?
How long have you considered this decision?
When will the cat go outside?
Where will the cat stay during the day?
Where will the cat be at night?
Where will the cat be kept when you go on vacation?
Will you declaw?YesNo
How will you keep your cat from scratching furniture?
What do you consider valid reasons for giving up a pet? (Mark all that apply)
Will cat be family pet for:
Cats often live in excess of 12 years, are you prepared to assume responsibility for that long?YesNo
Pet Ownership History Have you ever had to give up a pet? If so, why and to whom? Are all of the pets in your household current on their shots? YesNo Are all cats in the household tested for Feline Leukemia/FIV? YesNo Are all dogs you have now on heartworm prevention? If so, what kind of heartworm preventative do you use, and what is the date of last heartworm preventative given? Flea and tick prevention used in your home? If so, what brand?
Have any pets in your household been diagnosed with the following infectious diseases or conditions?
Please list all pets currently living at your address (List Species, name of pet, age of pet, Gender, length of ownership, and if they are Spayed/Neutered)
Please list any previous pets owned in the last 5 years that are no longer with you (List Species, name of pet, age of pet, Gender, length of ownership, and if they were Spayed/Neutered)
What happened to the above listed pets that are no longer with you? (Please explain in detail)
List all Veterinary Clinics used in the past 5 years (Please provide vet's name, address, and phone number)
Please describe the extent of care that you are willing to provide should your dog have special medical needs now or later in life:
Are you familiar with:
My Current Veterinarian is Release for Veterinary Reference: (to be completed by potential adopter) I, (name), hereby give permission for any veterinarian providing service to me to release medical information on any/all of my animals to Fuzzy Friends Rescue, including the pet I'm adopting at this time for follow-up purposes in the case of existing conditions or simply well check and heartworm prevention status. When/why was your last vet visit? How did you hear about Fuzzy Friends Rescue? (please be specific) May we thank them for the referral?
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Phone (254) 754-9444 | Fax (254) 754-9959 | 6321 Airport Road, Waco, Texas 76708 |