pear_program

 

 


RESPONSIBLE PET OWNERS ALLIANCE
ADOPTED PET INFORMATION FOR THE NEW OWNER


Date:__________________                              Adoption Fee:_____________________

Name of New Owner:_____________________________________________________

Address:_______________________________________________________________

Street, City, State, Zip Code:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Home Phone:____________________              Work Phone:______________________

Species: _____Dog     _____Cat     _____Ferret      _____Bird   _____Reptile         
         ______________Other      BREED:_______________________
Sex:     _____Male     _____Female          Spayed or Neutered:     _____Yes    _____No
         If No:  Required by ____________________
Shots given:_____________ Date___________  Shots Due:________ Date__________
                   ______________Date___________                   ________ Date__________
                     _____________Date___________                    ________ Date__________
Rabies Tag #:  ___________ Clinic Name:  _________________ Due Date: _________
Microchip #: ____________________ Tattoo #:  ______________________________
Medications or treatments given: ______________________________________________________________________

Medications or treatments needed:  ______________________________________________________________________

Behaviors noted while in Foster Care:  ______________________________________________________________________

Special needs and/or comments: ______________________________________________________________________

As the new owner, I accept full responsibility for the care and actions of this animal and agree to indemnify and hold harmless the Responsible Pet Owners Alliance, Inc. and/or their agent or rescuer from any liability concerning said animal.

It is possible that these pets have been exposed to canine and feline disease that may not show symptoms for several weeks, as would be the case regardless of where you get your pet. There is even a chance that a healthy animal can carry a disease that is transmittable to people. The adjustment period for a new pet can be quite challenging. Along with advice from your veterinarian, obedience classes are recommended for all dogs to help you understand your animal’s behavior and help it adjust to the new family.

New Owner’s Signature: ____________________________    Date________________

RPOA Rescue Agent: ______________________________    Date________________

                       Phone:  ______________________________




 

 

 

 

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