Adoption Application

hello@havenanimalrescuenebraska.org

Haven Animal Rescue Nebraska utilizes home-based fosters so our pets are acclimated in a house environment where they will be socialized, trained, and rehabilitated. We do not have a facility and are all volunteers, so please allow 5 to 7 days for processing your application. If you are considered a match for our animal, we will contact you for an in-person meet-and-greet pending home check approvals. In addition, please note we only adopt out animals that will be inside pets and live as a companion indoors.

All of our adoptable animals are up-to-date on vaccinations, rabies, spayed/neutered, and microchipped. All dogs are also Heartworm tested if they are the appropriate age and current on Heartworm and Flea/Tick Preventatives. Our cats are also FeLV tested. Additional medical care may have been completed as needed per each individual pet. Haven Animal Rescue Nebraska utilizes home-based fosters so our pets are acclimated in a house environment where they will be socialized, trained, and rehabilitated. We do not have a facility and are all volunteers, so please allow 5 to 7 days for processing your application. If you are considered a match for our animal, we will contact you for an in-person meet-and-greet pending home check approvals. In addition, please note we only adopt out animals that will be inside pets and live as a companion indoors.

Please list the animals you are interested in.

Name

First Name

Last Name

Significant Other's Name (If applicable)

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Your Date of Birth

YYYY

Your Occupation

Significant Other's Occupation (If applicable)

Please list names and ages of all in the household.

Have any children living in your home lived with or been around dogs? Please describe their level of experience around animals.

Do you have any children, not listed in the household, visit your home and interact with your pets? Please describe what their level of interaction will be.

How do you plan to exercise your new pet?

Please describe the method or type of training you use on your pets.

Do you own your home or rent?

If you rent, please provide your landlord’s contact information.

Do you have a fully enclosed fence?

If yes, please describe height and style?

Where will the pet be when you are not home?

What is the average number of hours a day the pet will spend alone?

Where will the pet sleep at night?

Please list all current pets, by name, in the household. Include: Name, age, species, and gender.

Are all current pets up-to-date on rabies and other vaccinations?

Do you do an annual heartworm test on your current pets?

Do you use heartworm preventatives on your current pets?

What is the name of the heartworm product being used?

Do you use flea/tick preventatives on your current pets?

What is the name of the flea/tick product being used?

Are all your current pets spayed/neutered? If not, please explain why.

Please list your veterinarian, their address, and their phone number? (*Note we cannot process your application without this information. Please call the clinic and give them permission to speak with us.)

Please list your past pets by name and why you no longer have them. If they saw a different veterinarian than listed above, please include that veterinarian(s) and their phone number.

For what reason do you ever see yourself surrendering a pet?

Please tell us a little about yourself. What are your interests or hobbies?

Please tell us why you’d like to add a pet to your family and what the most important characteristics you would like in a new pet.

Are all members of the household in agreement to adopt?

Please list two references. Include: Name, relationship to you, their address, and their phone number. (*Only one of them may be a family member.)

By submitting this application, I/we are certify that all questions have been answered truthfully and that this submission does not guarantee placement of an animal. In addition, I understand that owning a pet is a lifetime commitment and realize new pets may need an adjustment period in a new environment. I/We agree that by submitting this form a willingness to do so. ONCE YOU SUBMIT YOU WILL BE REDIRECTED TO OUR HOMEPAGE AND YOUR APPLICATION WILL AUTOMATICALLY BE SENT.

I agree