Pet Name     Description
We are committed to placing pets in the best possible homes. Please provide the following information to assist the pet's current guardian.
Adopter's First Name     Last Name
Address     City     Zip
Phone     Alternative Ph. *
I currently live in a House Condo Apartment Townhouse
  How long at this address?
Are there screens on the windows and doors? Yes No
If renting, are pets allowed? Yes No
Number and ages of children living at home
Have you ever surrendered a pet to a shelter/pound? Yes No
  If yes, describe circumstances
Have you ever owned a pet before? Yes No
  What type of pet did you have?
  What happened to the pet?
Are your pets altered? Yes No
Are your pets current with vaccines? Yes No
May we call your vet as a reference? Yes No
  If yes, who is your vet (name, address, ph no.)?
Have you ever cared for a sick animal? Yes No
My new pet will be Indoors Outdoors Both
Where will your new pet live/sleep?
If cat, have you ever had a cat declawed? Yes No
  Do you plan to declaw this new cat? Yes No
What will you do with your pet if you have to move?
What will you do with your pet if you or someone develops allergies?
What will you do with your pet if you or your spouse becomes pregnant?
I agree and understand that this animal is being offered for adoption by the pets current guardian as part of Safe Haven Animal Sanctuary's Guardian Adoption Program. This animal is not offered by Safe Haven Animal Sanctuary and does not come with any benefits or rights of a SHAS fostered adoption.
I agree and understand that Safe Haven Animal Sanctuary makes no representations regarding the truth and accuracy of any statements contained in this pet's biography. The pets' current guardian provides all representations contained therein.
I agree and understand that I am completely responsible for the care and treatment of this animal once I adopt this animal from its guardian.
I agree and understand that Safe Haven Animal Sanctuary is not responsible for the care or treatment of this animal, nor any veterinarian bills this animal may have or will incur.
* denotes optional
Back to top

Safe Haven Animal SanctuarySM
Mailing: PO Box 9005
San Jose, CA 95157
Telephone: (408) 420-SAFE (7233)
Fax: (866) 833-2451 (toll free)
Follow us on Pinterest 
Please report any technical issues to:

Copyright © 1999-2017
Designed & Maintained by