• Email address*
• Name
  First Name Last Name
• Address
  Street Address

  Street Address Line 2

  City State / Province

  Postal / Zip Code
• Phone Number
   - Area Code Phone Number
• Emergency Contact Name
  First Name Last Name
• Emergency Contact Phone
   - Area Code Phone Number
• Choose one of the following:*
  YES, I agree to give Pethealth Inc & Hill’s Science Diet their companies and third parties permission to provide me with electronic messaging that includes free 30-day health insurance for my new pet. NO, I do not wish to give this permission. I waive free 30-day health insurance for my new pet and deny third party distribution of my email address. Pethealth will not be able to contact the pet owner in the event that their pet goes missing
• Verification*
  I verify that I am 18 years of age or older, have identification showing my current address, and have knowledge and consent of my landlord. I understand falsification of information will lead to rejection of this application. I understand filling out an application does not reserve or hold an animal for me prior to adoption and that HES reserves the right to refuse adoption to anyone.
• Are you interested in a specific pet that you have met at the shelter or seen on our website? Please let us know who your top choices are.
• What kind of pet are you interested in? Check all that apply.*
  Kitten Adult Cat Senior Cat Puppy Adult Dog Senior Dog
• What size pet are you looking for?*
  Small Medium Large Huge
• Why are you interested in adopting a pet? (check all that apply)*
  Companion Child's pet Gift Guard dog Company for Other Pet
  
• What qualities are you looking for in a pet? (check all that apply)*
  Friendly Playful Affectionate Energetic Aggressive Quiet Gentle
  
• What energy level are you looking for?*
  High Energy (Daily vigorous exercise) Medium Energy (A daily walk) Low Energy (Couch buddy)
  
• How do you feel about the following behaviors?*

  	OK or Manageable	Cannot tolerate
  Jumps on people
  Chews
  Mouthy
  Doesn't like other animals
  Doesn't like kids
  Destructive inside
  Separation anxiety

• If a behavior cannot be tolerated or changed after adoption, what steps would you take?*
  Return to shelter Give away Consult a professional trainer
  
• Do you currently have pets in the home?*
  No Yes
• If you do have pets in the home, please describe them below.
• If you do have other pets, what kind of identification do they have?
• How many people are in your household?*
• What are the ages of the people in your household?*
• Where do you live?*
  House Apartment Condo/townhouse
  
• Do you own or rent?*
  Own my own home Rent Live with parents or homeowner
  
• If you rent, is a pet deposit required?
  Yes No Don't know
  
• If you rent, provide the name and phone number of your landlord. If you live with your parents or the homeowner, please provide their name and phone number. *Required if you do not own your home*
• How many hours will your pet be left alone each day?*
  1-2 hours 3-4 hours 4-6 hours 8-10 hours 10+ hours
  
• What are your plans for your pet when you are NOT at home? Please describe in detail.*
• What are your plans for your pet when you are AT HOME and AT NIGHT? Please describe in detail.*
• Do you have a fully fenced yard?*
  Yes No
  
• How would you describe your lifestyle? What does a typical day look like for you?*
• Tell us about your past experience with pets.*
• How long did you have previous pets and why are they no longer with you?*
• Do you have a regular veterinarian?*
  Yes No
  
• If so, which veterinarian?
• Are all pets you currently have up to date on annual vaccines?
  Yes No
  
• Please tell us anything else you would like to share about you, your family, your lifestyle, your ideal pet, your past pets, or anything else.
• Shelter hours are Monday-Saturday, 12pm-5pm with appointment. What is your availability for an adoption appointment? Expect to spend at least 30 minutes in person at the shelter.
• Submit
• Should be Empty: