Pet adoption form - Riverbrook Animal Hospital

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Adopt a dog, cat, kitten, or puppy from Riverbrook Animal Hospital

Please fill out the following pre-adoption information.
Your responses help us to better match you and your new pet.

Fields with ** are required so that we may contact you to discuss
your potential adoption of a pet.

First name **

Last name **

Home phone (i.e. 918-748-4400) **

Work phone (i.e. 918-748-4400)

Address **

City, State, Zip **

E-mail **

Which pet are you interested in? (ID#)

Why do you want a pet? **

How did you hear about Riverbrook's rescue animals?
I do not recall
Saw the Web site
Saw newspaper ad
Friend suggested Riverbrook
Other referral source

Have you ever owned a pet?
Yes
No

Why did you decide on this dog/cat breed?

Please tell us how many other pets you have.

Are your other pets spayed/neutered? **
None
Some
All

Please list ages of your children. **

Does your house/apartment have a securely fenced yard? **
yes no

Where will your new pet sleep? **

Where will your new pet stay during the day or while you are away? **

What kind of outside shelter will you provide for your pet? **

Does your daily schedule allow time to give your new pet plenty of attention? **
Yes No Don't know

If you are adopting a dog, would you be interested in attending obedience classes?
Yes No Don't know Not applicable

If you adopt a cat, do you intend to let it go outside?
Yes No Don't know Not applicable

Are you prepared for the ongoing responsibility and expense of visits to the
veterinarian for checkups? **
    Costs: shots - up to $50/year; heartworm prevention - $25 to $75/year;
    flea control - $25 to $80/year; cost for boarding if needed ($8 to $10/day);
    cost for food; additional cost for necessary medical attention.
Yes No Don't know

Are you willing to make a commitment for the lifetime of this pet? **
Yes No Don't know

When do you plan to come to the clinic to meet your prospective adoptable pet? **
I will call the clinic (918-748-4400) to arrange to see pets Monday-Friday
I will call the clinic (918-748-4400) to arrange to see pets Saturday

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Jana Layton, D.V.M.
Riverbrook Animal Hospital
3750 S. Peoria - Tulsa, OK 74105
Phone (918) 748-4400
Fax (918) 748-4402
E-mail info@riverbrookpetvet.com

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