Have a Heart Cat & Kitten Adoption Application

Have a Heart Animal Rescue Cat & Kitten Adoption Application
Dear applicant:

Thank you for your interest in adopting from us! We are an all volunteer, 501C3 animal rescue group in Birmingham, Alabama. We focus our efforts on pulling kittens and cats from shelters in rural Alabama areas. Our mission is to place all of our animals in loving, permanent homes. You are not purchasing a pet from us; you are adopting a living, breathing, creature that deserves safety, love and care.

Your answers to this questionnaire are assurance to us that the cats we care for are going to good, permanent homes. All of the information on this application is confidential. You must be at least 21 years old to adopt.

We do not use a first-come, first-serve process when adopting out cats. Instead, we focus on best fit for each individual cat. The process is intended to ensure a long-term successful adoption for both the family and pet.

Cats can live for 15-20 years, so please make sure your lifestyle allows the time, patience, and ability to cover expenses your new pet will need over the years. Will you be travelling frequently, moving soon, or having children? Responsible pet ownership includes as-needed and routine veterinary care, quality food, preventatives, and other supplies.

All of the cats and kittens available for adoption are fully vetted with age appropriate vaccinations and a veterinarian checkup, combo tested for FeLv and FIV.

The adoption fee is $100 for kittens and cats.
General Information
Name of Applicant*

First NameLast Name
Age of Applicant*
Applicants must be at least 21 years old to adopt
Name of Co-Applicant

First NameLast Name
Email Address*
Cell Number*

Area CodePhone Number
Alternative Phone Number

Area CodePhone Number
Employer*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Driver's License # and State*
What type of cat are you interested in adopting? Check all that apply.*

Kitten(s)AdultSeniorUndecided / no age preference
NOTE: Due to the fluctuating availability of kittens and the high-volume of kitten applications we receive, it takes time to review applications. This isn't a quick adoption process. As we require a vet reference, phone interview, meet and greet and a home visit. (May vary depending on circumstances)

As a note, the wait time to adopt or foster to adopt kittens can take anywhere from a couple days to a couple of weeks. The reason for this is because kittens need to make sure they have reached a certain level of socialization and development (based on their age and weight). This wait time is applicable for all kittens and also for adult cats depending on health situations.
Are you interested in adopting a specific cat/kitten?*

Yes - I am applying for a cat/kitten I saw onlineYes - I am applying for a cat/kitten I met in a foster homeYes - I am applying for a cat/kitten that I saw on FacebookNo - I am still considering all optionsOther
Which cat(s)/kitten(s) are you interested in adopting?*
List the name(s) of all cats you're interested in
Describe the type of personality and/or appearance you would like your cat/kitten to have:*
Ex: playful, friendly, lap cat, good with kids, good with other dogs, male, orange etc.
If the cat(s) you are interested are no longer available for adoption, would you like us to consider you for another cat/kitten that interests you?*

YesNo
If so, what is the cat/kittens name (please put N/A if not one):*
Ex: playful, friendly, lap cat, good with kids, good with other dogs, male, orange etc.
Who is this pet for?*

MyselfMy familyRelativeFriendOther
Are all members of the household aware of the adoption and in agreement?*

YesNo
Have you applied to adopt from Have a Heart Animal Rescue previously?*

YesNo
Have you adopted from Have a Heart Animal Rescue previously?*

YesNo
Are you looking to adopt now, or in the future? *
If future, please provide an estimate as to when you'll be ready to bring home your new cat
Home & Family
Describe your home*

Single-FamilyApartmentCondo/DuplexPublic HousingStudent Housing
Do you own or rent your home?*

OwnRentI live with a parent, guardian or family member
If you rent or live in a family member's home, please provide their contact information here:
Who else lives in the home or visits regularly? Please list names and ages for individuals under 18 years of age.*
Ex: Michael, husband (41); Jessica, daughter (7). Susan, mother-in-law (80).
Is your home busy or quiet?*

BusyQuietA mix of both, depending on the time & day
Are any members of the household allergic to pets (eg. dogs, cats etc.)*

YesNo
If you had to move, are you willing to find housing that accepts pets?*

YesNoMaybe
Current & Past Pets
Do you have any pets currently?*

YesNo

Have you had any pets of your own in the past 10 years?*

YesNo - this is my first pet

Have you ever had a pet euthanized?*

YesNo
If yes, please explain the circumstances:
Have your current or past cats been mostly indoor with some time spent outdoors? How often did they go out? Please explain:*
Do you plan to let your adopted cat out for outdoor time? If so please explain.*
Where will your cat live at your home?*

Indoors OnlyOutdoors OnlyIndoor & OutdoorsDon't know
Did you declaw any of your past or current cats?*

YesNoN/A - this is my first pet
Do you plan on declawing your adopted cat?*

YesNoI don't know
Are you willing/able to take your pets to yearly check-ups?*

YesNo
Are you aware of necessary vaccines for cats/kittens*

YesNoUnsure, this is my first pet
If your pet becomes ill, are you able to afford a veterinary bill?*

YesNo
How many hours per day would the pet be at home alone?*
How would you deal with behavioral issues such as excessive meowing, destructive behavior, inappropriate urination etc.?*
Does your home have space (i.e. a spare bedroom, office, or bathroom) to separate new pets from current pets during the acclimation and introduction period?*

YesNo
Are you willing to give your cat/kitten time to adjust to its new environment? (Note: this could take anywhere from several days to several months)*

YesNo
If you have to leave town, urgently or planned, where would your cat stay or who would take care of it?*
If you were no longer able to care for your pet, or had to move, what would happen to your pet?*
Have you ever had to re-home a pet or surrender it to an animal shelter, animal control etc.?*

YesNo
If you answered "Yes" to the above question, please explain the circumstances:
Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo
If you answered "Yes" please provide a detailed description:
Are you willing and able to care for your cat for the full duration of its life (15-20+ years)?*

YesNo
Veterinarian

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

Area CodePhone Number
Last name that the pet(s) are listed under (if applicable):*
Previous Vet Clinic
Previous Vet Clinic

Area CodePhone Number
Do we have your permission to contact your vet(s) for a reference?*

Yes, you may contact my vet.No, you may NOT contact my vet.N/A, This is my first pet
Terms & Conditions
I certify that I am at least 21 years of age*

AgreeDisagree
The information I have provided on this application is true. I also recognize that any misrepresentation or omissions may result in the loss of privilege to adopt from Have a Heart*

AgreeDisagree
I understand that Have a Heart has the right to deny any application for any reason*

AgreeDisagree
I understand that Have a Heart is not able to guarantee the health or temperament of any cat, as many cats come in with unknown histories. There are traits that could change upon adoptions and I take responsibility to care for and address these issues if they do arise*

AgreeDisagree
I understand that I am to immediately contact Have a Heart in the event that my adopted cat is lost/missing*

AgreeDisagree
I attest that the cat I am adopting is for me, in my home, and NOT a gift for anyone*

AgreeDisagree
I understand that I am responsible for paying for all follow-up vaccines, wellness visits & medical procedures my pet will require in the future.*

AgreeDisagree
If I am adopting a kitten that is too young to be fixed at time of adoption (this is considered foster-to-adopt), I understand that I am to keep it separate from my other cats until it is FIV & FeLV tested.*

AgreeDisagreeN/A - I don't have any cats currentlyN/A - the cat I am applying to adopt has already been combo tested
I hereby authorize Have a Heart representatives to contact my veterinarian(s), and landlord to verify said statements in the questions above.
Signature of Applicant*

First NameLast Name
Date*

MonthDayYear
Date
Should be Empty:

	Name	Type of Animal	Sex (M/F)	Age	Fixed? (Y/N)	Up-to-date on vaccines? (Y/N)	Vet Clinic Used	Vet Clinic Contact information
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

Have a Heart Animal Rescue Cat & Kitten Adoption Application

General Information

Home & Family

Current & Past Pets

Veterinarian

Terms & Conditions