Meet Your Match Form

Name

First

Last

Your Physical Address

City & State

Zip Code

Best Phone # To Reach You At (xxx-xxx-xxxx)

Best Time To Reach You

Email Address

Are you 18 years of age or older?

Yes

No

Are you head of your household?

Yes

No

Are other adults in your household in agreement with you adopting a pet?

Yes

No

Do you, or anyone living at the pets’ new household, have a history of violent or sexual crimes, animal cruelty or abuse?

Yes

No

Name of pet(s) you are interested in adopting:

If you do not know the pet's name, use 'unknown".

Activity Level of pets you are interested in:

(example: active, hyper, calm, laid back)

Are you adopting this pet for someone other than yourself?

Yes

No

If yes, Who?

If "No"... enter "N/A"

Do you live in. . .

City

Town

Country

Farm

Do you live in a. . .

Do you...

Own

Rent

Live with parents/family

If rent, does your landlord allow pets?

Yes

No

No Landlord

Is there a pet deposit you must pay the landlord?

Yes

No

No Landlord

If renting, Name and phone number of landlord:

If you are not renting write "none".

What kind of pet are you looking for?

Inside only

Outside only

Inside / Outside

Will the pet have access to the outside via a pet door?

Yes

No

If no, could you install a pet door?

If "Yes", enter "N/A"

Will the pet have access to a front or back yard?

Yes, with a tall secure fence

Yes, with a short secure fence

Yes, with a tall non-secure fence

Yes, with a short non-secure fence

I have a yard with no fence

I have no yard

If no yard or fence, what is your safety plan?

If you have a yard, enter "N/A"

Average number of hours you are gone per day?

Will your pet be kenneled/crated when you are gone?

Yes

No

Where will your new pet sleep?

Inside

Outside

Number of adults in home:

Number of children under 18 in your home and their ages:

If none... enter "0" or "None"

How often do visiting children come?

What are their ages?

If no children visit, enter "none"

Why do you want to adopt this pet?

What activities will you share with your new pet?

How many pets do you have now?

Are all your pets currently Spayed or Neutered?

Your Veterinarian’s name and phone:

How did you hear of this pet?

Friend, Newspaper, Online, Adoption event, or how?

I give permission for photos to be taken of my new pet and myself/my family at the time of adoption, to be used by HSO in social media posts and/or shared with grantors for their use.

Yes

No

Type in your name if you agree to the following statement

By submitting this form, I acknowledge that adopting a pet is a lifetime commitment, usually lasting 10 to 15 years. I understand that this form is only a questionnaire/application for adoption, and upon approval by HSO, I will sign an adoption contract.

Today's date

Captcha

Thank you for your interest in one of our fine pets!

Meet Your Match!

Humane Society of the Ouachitas

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