Adoption Application Citrus County Animal Services Page 2
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2PET HISTORY: What pets do you currently have in your home? Please include all dogs, cats, and ferrets.
Type of Animal
Age
Sex
Sterilized?
Kept Where?
How Long
Last Vet
Owned
Appointment
Have you ever brought an animal to a shelter under any circumstances?
☐ yes
☐ no
If you answered yes, please explain.__________________________________________________________
_______________________________________________________________________________________
How did you hear about us? ☐ Newspaper
☐ Television
☐ Website
☐ Pet Store
☐ Repeat Customer
☐ Friend ☐ Other_______________________
I also want this pet to be (Check all that apply) ☐ Watchdog
☐ Companion
☐ Hunter
☐ Breeder
☐ House Pet
☐ Mouser
☐ Companion for other pets
☐ For the Children
How many hours a day will the pet be left alone?___________Where will pet be kept during the day?________
Where will pet be kept during the evening?______________________________________________________
If you plan to leave pet outdoors, describe outdoor shelter you will provide:
_______________________________________________________________________________________
How will you keep pet confined to your property? Check all that will apply.
☐ In House
☐ Kennel
☐ Fenced Yard
☐ On Chain
☐ Garage
☐ Patio
☐ Tethered
☐ Puppy Day Care
How will you exercise the dog?_______________________________________________________________
If something were to happen to you, what plan do you have for your pets?_____________________________
Citrus County Animal Services reserves the right to do a wellness check on any pet at any reasonable
hour. By signing this form you acknowledge that until the animal is out of the care and custody of Citrus
County Animal Services, Citrus County retains the right to revoke the adoption for good cause.
I certify that all the information in this application is true & I understand that false information may void the
application.
_____________________________________________________
____________________
Signature
Date
Print
Submit
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Parent category: Legal