Application

Submitting this form will generate an email to you using the email address provided in the form. IF YOU DO NOT RECEIVE A CONFIRMATION EMAIL, THE FORM WAS NOT SUBMITTED CORRECTLY. 

Please complete this application as thoroughly as possible so that we can assist you in selecting the right animal for you, your family and your lifestyle. We must be allowed time to process your application, as we wait for return phone calls. Please carefully consider your decision to adopt a pet for life. The Humane Society of Erie County (HSEC) has the right to deny any application.

Falsification of information provided is cause for denial of adoption. Please be advised that we do thorough background checks and we reserve the right to deny any adoption application. If you wish to download the application instead, you can do so here. Please send your completed application to hsec.1911@gmail.com.

Veterinary Release

Some veterinarians require verbal confirmation from their clients in order to speak to us. It is highly recommended for you to call your veterinarian and give such approval to expedite your adoption application. HSEC will contact your veterinarian.
I hereby give permission for any veterinarian providing services to me to release medical information on any/all of my animals to the HSEC*:
Date*:

Adopter information

Name of pet you are submitting an application for*:
Your Name*:
Please list all adult members of your household including Name/Relation/Age*:
Address*:
City*:
State*:
Zip*:
Current County* (i.e. Erie County, etc.):
Phone*:
Previous addresses in the past two years*:
Previous county in the past two years*:
Email Address*:
If you have adopted an animal before, please list the animal, where you adopted from and when*:
Lifestyle*:
Do you own your home?*:
If you rent, have you spoken to your landlord about a pet?*:
Breed/size limit?*:
Landlord/apartment name & phone*:
Do you anticipate major life changes in the next five years (moving, children, etc)? Please explain*:
Do children live in the home or visit the home often? If yes, list ages*:
Do the children have experience with dogs or cats?*:
Does anyone in the home have asthma/allergies to dogs/cats?*:
Does anyone in the home have a criminal record? Please explain*:
Do the adults in the home work? Occupations? Full or part time?*:
Does the home have a yard?*:
Fencing*:
Do you have renters/homeowners insurance?*:
What company?*:
How many hours a day will your pet be home without adults?*:
Where will you keep your pet when you are away from home?*:
Who will be the primary care giver for your pet?*:
What arrangements will you make for your pet when you take trips?*:
Where will this pet sleep?*:
Do you feel confident you will be healthy and able to care for a pet for it’s life expectancy of 15-20 years?*:
What type of personality and level of activity are you looking for in a pet?*:
How do you plan to give your pet exercise?*:
Have you considered the added time necessary for proper care/training/exercise of your pet and you are willing and able to provide that time?*:
Are you aware that this pet may NOT be house trained?*:
Are you willing and able to purchase a crate if needed/advised?*:
Do you realize that this animal may chew/scratch items in your home?*:
Do you realize that this animal will shed and will require regular grooming?*:
Do you understand that HSEC does not guarantee the health of its animals and that immediate medical care (at your expense) may be necessary?*:
Have you considered all the added costs of responsible pet ownership and you are willing/able to take on those extra costs?*:
Are you willing to take your animals for routine, annual veterinary care?*:
Do you understand that any pets in your home should be up to date on vaccinations prior to introducing a new pet to the home?*:
Please list your current pet(s)*:
Is your dog licensed?*:
If so, what county?*:
Have you had pets in the past? Please explain what happened to them*::

Veterinarian Information

Please list name and phone number of any/all veterinarians you have used:
Practice/Doctor #1*:
Phone number*:
When were you a client?*:
Owner name on file*:
Practice/Doctor #2*:
Phone number*:
When were you a client?*:
Owner name on file*:
It is important to understand that it will take time for a new pet to settle into a new environment. Sometimes decompression (space in the home away from otherpets/children) will help the pet be comfortable in the home. There may be disruptions with “bad” behaviors such as chewing, potty accidents, anxiety,barking, etc in your home during the adjustment period. While there is no way to predict when an animal will be completely settled into a new home, we ask that yougive the animal a month to get acclimated. Are you willing and able to provide the necessary time and adjustments to allow the animal to acclimate to your home?*:
Please list a personal reference whom we may contact (Name/relation/phone number)*::
How did you hear about HSEC?*:
What is your reason for wanting a pet?*:
What is your favorite thing about owning a pet?*:
What is your least favorite thing about owning a pet?*:
I am capable of handling and interacting with the animal I propose to adopt and I am prepared to demonstrate this to the satisfaction of the HSEC. I understandthatcompletion of this application is NOT a guarantee that I will be allowed to adopt a dog or cat of my preference, and that the HSEC has the right and responsibilitytodeny any adoption. By submitting this application, I give permission to the HSEC to investigate and confirm the information I have provided. I understand that Iamlegally responsible to procure a dog license for my new dog in my county of residence.*:
Date*:
Full name*:
 

Your application will be reviewed and processed by HSEC, and we will contact you as soon as possible.

If approved and we move forward with an adoption, a legally binding adoption contract will be signed along with payment of adoption fees. Cash and credit card are accepted.

Thank you for submitting your application!