E.C.R.C. Adoption Application

Veterinarian Reference:

Please list your current / previous / planned veterinarian(s) and their phone number(s). We will contact them to verify your current pets are up to date on shots, fixed and FeLV tested; this is a requirement for new pet adoptions. Please call their office(s) to authorize release of information to us. If you are planning to utilize another vet but are not currently a client, please note that information.
Do you currently have a vet?

Yes.No.
Vet Clinic*
Vet Clinic Phone*
Last name that the pet(s) are listed under (if applicable):*
Previous Vet Clinic
Previous Vet Clinic Phone
Personal References

Please provide 2 non-family references (eg. neighbors, coworkers, family friends etc.)
Reference 1*

First NameLast Name
Reference 1*
Relationship to Reference 1*
Ex. Neighbor, coworker, roommate, family friend
Reference 2*

First NameLast Name
Reference 2*
Relationship to Reference 2*
Ex. Neighbor, coworker, roommate, family friend

ADOPTION FEES, FOSTER-TO-ADOPT, MEDICAL CARE:

CONTRACT INFORMATION
I hereby agree that the required adoption fee covers *only* the expenses for *pre-adoption* medical care listed, including Spay/Neuter, Puppy (DAPP)/Kitten (FVRCP) series vaccines, Rabies vaccine, Microchip, rescue administered deworming treatment(s), wellness/intake exam(s).*

Agree
Adoption fees must be submitted at the time of Foster-to-Adopt. All adoption fees are non-refundable after the Foster-to-Adopt period of 14 days. Adoption fees will not be refunded at any point after 14 days including if any pet is returned, reclaimed or surrendered as per earlier listed articles of this agreement. If said pet is returned prior to end of 14 day trial period for any reason, and is not returned with any/all belongings provided at time of adoption, refund of adoption fee is waived by Adopter*

Agree
I agree to submit any required adoption fee prior to Foster-to-Adopt, via Venmo, CashApp, Zelle, PayPal or Cash. *Currently, credit cards are not an accepted form of payment of any adoption fee**

Agree
**ADOPTION FEES ARE NON-REFUNDABLE AFTER THE 13th DAY IN FOSTER-TO-ADOPT. NO EXCEPTIONS. Foster-To-Adopt animals must be returned prior to 5p on Day 13 of the Foster-To-Adopt period in order to be considered to receive a refund of submitted adoption fees. All refunds are considered on a case-by-case basis. If the minimum 14 day Foster-To-Adopt period is not completed, the Adoption fee shall be forfeited. If after Day 14, all adoption fees are non-refundable regardless of circumstances.

Agree
I understand that I am to immediately contact Emerald City Rescue Coalition in the event that my adopted dog/cat is lost/missing*

Agree
I understand and agree that *all* veterinary care during Foster-To-Adopt is to be provided solely through Emerald City Rescue Coalition's approved Veterinary and clinic partners. If a clinic/vet care appointments is refused by adopters, through an approved ECRC partner, any and all care expenses shall be the sole responsibility of the adopter, but this does *not* result in approved adoption or transfer of ownership. Any veterinary care during Foster-to-Adopt is covered by Emerald City Rescue Coalition *only* if provided by approved Veterinary/Clinic partners.*

Agree
If Adopter opts to visit their own vet for care during Foster-to-Adopt, *after speaking with Emerald City Rescue Coalition staff*, this classifies as unapproved care. No refund of Adoption fee, or reimbursement of care expenses will be provided. This does *not* result in any early finalizing of adoption/transfer of ownership. Adopters further agree to give permission to ECRC staff to obtain visit medical records, invoices and chart notes, along with giving permission for ECRC staff to contact and speak with their vet. Any adopted pet will remain under their pre-adoption name, for continuity of records.*

Agree
I hereby authorize Emerald City Rescue Coalition to contact my references, veterinarian(s), and landlord to verify said statements.
Applicant Name*

First NameLast Name
Signature*

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Date*

MonthDayYear
Date
Emerald City Rescue Coalition 2023
Should be Empty:

	Name	Type of Animal	Sex (M/F)	Age	Fixed? (Y/N)	Up-to-date on vaccines? (Y/N)
Pet 1
Pet 2
Pet 3
Pet 4
Pet 5

	Name	Type of Animal	Sex (M/F)	Age	Why don't you have them any longer?
Pet 1
Pet 2
Pet 3
Pet 4

Emerald City Rescue Coalition

Prospective Adopter Information:

Home and Family Information:

Current & Past Pets

Veterinarian Reference:

Personal References

GENERAL TERMS AND CONDITIONS:

ADOPTION FEES, FOSTER-TO-ADOPT, MEDICAL CARE: