Adoption Application Citrus County Animal Services
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1
2ADOPTION APPLICATION
CITRUS COUNTY ANIMAL SERVICES
4030 S. Airport Rd.
Inverness, Fl. 34450
Office: 352-746-8400
|
Fax: 352-726-4120
Print Your Name
Date
test
Address
City
State
Zip
Home Phone
Cell Phone
Email
Please read the following section carefully. In order to be considered as an adopter, you must:
•
You must be 18 years of age or older.
•
Have current photo identification showing your age and present address
•
Be willing and able to provide training, medical care and loving attention for a pet
•
Be willing to take your new pet to a veterinarian within 5 days for examination and treatment, at your
own expense.
•
Have your new pet vaccinated against rabies and purchase a Citrus County License annually.
•
Provide your new dog with heartworm prevention medication throughout its life.
•
Abide by all the rules in the adoption contract and follow all County Ordinances.
Understand that Citrus County Animal Services reserves the right to deny any adoption application.
PERSONAL INFORMATION
:_________________________
Name of Veterinarian_______________________
Check Type of Housing:
☐ Own House
☐ Own Condo
Rent House*
☐
☐ Rent Apartment/Mobile*
☐ Government Housing*
☐ Boarding*
If you do not own your home/property, have you checked with your landlord to make certain you are permitted
to have a pet at this residence?
Yes ☐
No ☐
How long at present address __________ Are you planning on moving in the next 6-12 months?_________
If you ever move, what will you do with your pet?________________________________________________
Do you have access to a yard? Yes ☐
No ☐
Approximate size?______________________________
Yard is: ☐ open
☐ fully enclosed
What type of fence?________________Height of fence______
Who will be responsible for the pets care?_____________________________________________________
Does anyone in the household have animal allergies?____________________________________________
________________________
__________________
Adoption Counselor Signature
Description of animal
☐approved ☐denied
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