ADOPTION APPLICATION

Safe Haven Pre-Adoption Form

*All fields must be filled in. Incomplete forms will not be processed.

The SAFE HAVEN Humane Society appreciates your concern for homeless animals. We respectfully request that you complete this Pre-Adoption Application so that we can assist you in finding a suitable companion pet. SAFE HAVEN respects and strictly adheres to the regulations set forth by the Illinois Animal Welfare Act, which specifically stipulates that any adopted animal must be spayed or neutered. A new pet must also be properly inoculated with special attention to rabies. I understand that SAFE HAVEN must approve of my ability to be an adoptive family for a SAFE HAVEN companion pet. An adopted animal must be examined by a veterinarian within 7 days following adoption.

If you are 18 years of age or older and have a valid ID showing your current address, you may complete the following:

 
 

We will send an email to this address when we receive your application during our regular business hours Mon – Sat, 10am to 3pm.


Work
School
Stay At Home
Other

Yes
No

House
Condo
Mobile Home
Apartment
Dorm

Yes
No

Active
Noisy
Quiet
Other-Explain

We will contact your vet. Please provide the name of the person on file for your pet if different than yours.


Yes
No

House
Basement
Outdoors
Yard
Pen
Crate

How many days per week?


Take with
Find another home

Yes
No

Adult Dog
Puppy
No preference

yes
no

Yes
No

Adult cat
Kitten
No Preference

Indoors
Outdoors
Indoors/Outdoors

Adoption fair
Newspaper ad
Website
Other