Pet Adoption Questionnaire | Licking County Humane Society

Potential adopters should visit the shelter to complete the processing of this questionnaire. We will not begin to process this form until then.

Completion of this questionnaire does not hold a pet or guarantee you will be matched with the pet.

NOTE: We do NOT adopt to those living outside of the state of Ohio.

Date*
MM slash DD slash YYYY
Cat or Dog?*
Animal's Name (list all animals you're interested in)*

Our website is current with all available pets. If you'd like to visit our open cat room, write 'cat area visit.' **The questionnaire will NOT BE ACCEPTED if anything other than the pet's name or 'cat room visit' is entered.**
Your Name*
First Last
Your Address*
Street Address Address Line 2 City State ZIP Code
County in Ohio*
We welcome adopters who rent or live in an apartment or condo. We want to alert you that some landlords and management companies have size and breed restrictions, limits on number of pets, and/or require pet deposits or additional fees. We suggest that you contact your landlord to make sure that the pet you choose is welcome in your complex. Please bring a copy of your lease with you when you come to the shelter and your landlord's contact information.
Your Email*
Your Phone Number*
What are you looking for in a pet? (be as DETAILED as possible)*
Is this pet meant to be a gift?*
- Yes
- No
Number of adults age 18+ in household*
First and Last name of ALL adults in your household*
Number of children age 0-5 in household*
Number of children age 6-11 in household*
Number of children age 12-17 in household*
Tell us about pets at home (check all that apply):
- I have one or more dog(s)
- I have one or more cat(s)
If applicable, list all pets in your home - provide age, breed, and size (small, medium, large):
Tell us how the new pet will spend its day (be as DETAILED as possible)*
Are you willing to work with a cat who:*
- has accidents or isn't litter trained?
- scratches furniture?
- door darts?
- hides or is shy for several weeks following adoption?
- needs several weeks/months to adjust?
- doesn't like being picked up or held?
- none of the above
please check the behaviors you're willing to work with
Are you willing to work with a dog who:*
- has accidents or isn't housebroken?
- door darts?
- hides or is shy for several weeks following adoption?
- needs several weeks/months to adjust?
- needs obedience training?
- occasionally chews or destroys things?
- has separation anxiety?
- is mouthy?
- barks a lot?
- pulls hard on a leash?
- none of the above
please check the behaviors you're willing to work with
Are you interested in declawing your cat?*
- Yes
- No
Are there other behavior or personality issues that you do not feel comfortable managing? If so, please list:
Other Questions or Concerns You Have Regarding Adoption
Agreement*
I understand that this questionnaire will not be processed until I visit the shelter and that submission of this questionnaire does not guarantee that I'll be matched with a pet.
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