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Adoption Application

  1. animal adoption form logo

  2. Animal Control Header

  3. Animal

  4. Adopter's Information

  5. Are there other Adults in the Household?

  6. Are the other members of your household in agreement with the adoption?

  7. Have they been spayed or neutered?

  8. Where will the new animal be housed?

  9. 9. If you marked both, what type of shelter will be provided for the new animal?

  10. Is your yard completely fenced in?

  11. What happened to them?

  12. If you have an animal in your residence now, have you ever introduced it to a new animal?

  13. If yes, how did your current animal react?

  14. Do You

  15. What Type

  16. Will landlord allow animals?

  17. Any restrictions?

  18. Who is your regular/previous veterinarian or what vet will you use?

  19. Do you agree to have annual checkups and all vaccinations administered by a licensed veterinarian?

  20. Do you agree to have annual checkups and all vaccinations administered by a licensed veterinarian?

  21. Are you on public assistance?

  22. 24. What is the reason for adopting this animal? (“X” all that apply)

  23. 25. Have you ever adopted an animal from a rescue league, humane society or animal shelter before?

  24. Application must be filled out in its entirety in order to be processed. Please answer all questions. Incomplete applications will not be processed. The City of Madison Heights reserves the right to deny adoption based on applications that do not meet our adoption criteria.

  25. I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

  26. Leave This Blank:

  27. This field is not part of the form submission.