dog and kids

Exotics Adoption Application

Please fill out all the fields below completely. Once we have received your application we will review it and contact you. Please allow for 24-48 hours after your application has been submitted. All information is strictly confidential.

Adopter Information

First and Last Name *
Street Address
City
State
Zip Code
Phone Number *
Alt Phone ​​​​​​​
Email
Alt Email

Animal to be Adopted Information

Animal's Name
Gender
Species
Estimated Age
Color / Markings
Known Medical Problems, if any:
Where did you first see this pet?

Adoption Questions

Have all your other pets (including dogs, cats, horses, etc.) been to the vet within the past year?
Are all of your current pets up to date on vaccines?
Are all of your current pets spayed/neutered?
Do your other pets take monthly heartworm prevention?
Do your current pets stay indoors, outdoors, or indoors/outdoors?

Veterinarian Information

Please fill in the following information if you currently have a veterinarian. If you do not currently have one, please fill in the information regarding the last veterinarian you used. If you have never owned a pet before please skip to the next section.
Name of Veterinarian
Clinic Name
Clinic's Phone Number

Adoption Agreement

I agree that this animal is being adopted for myself/my family, not as a gift for someone else and that I am at least 18 years old. I agree to provide for the needs of this pet through his or her lifetime including food, water, shelter, and veterinary care. If at any time I am unable to provide for this animal, I agree to either return him/her to Crossroads Animal Hospital/Crossroads Animal Rescue (CAH/CARE); surrender him/her to a rescue group (not a shelter or rescue who euthanizes healthy animals); or find another home who will provide for his/her needs. If this pet is returned to CAH/CARE, there will be no refund of the adoption fee. I understand CAH/CARE makes no guarantee about this animal’s health status or temperament. If this pet is not already spayed/neutered, I agree to have this surgery done by the time the pet is six months old. This requirement can be waived only with a written statement from the pet’s veterinarian stating that spay/neuter surgery is medically contraindicated. If you fail to have this surgery done by six months old (unless advised differently by your vet), we reserve the right to take back ownership of the pet. I understand that future medical care of this pet is my financial responsibility, including illness or injury that occurs shortly after adoption or any injury/illness known to be present at the time of adoption. This pet appears healthy at this time (or as indicated above under “Known Medical Problems”), but CAH/CARE makes no guarantee to future health.
By submitting this form you understand and agree to the terms listed above. You also agree that the information presented is true to the best of your knowledge. Again by completing this form, you are not obligated to adopted. The application is part of the approval process.
Confirmation *
Please use this comment section to provide any additional information you deem necessary to your application: