PKR Cat Adoption Questionnaire

This is a questionnaire for interest in adopting a Pawsitive Karma Pet. Please fill out this application truthfully and exact. A representative will be contacting you shortly. Thank you for your interest in adopting a rescue pet!

Adoption Policies: Individuals must meet the following criteria in order to adopt an animal from PKR.

- At least 18 years of age
- Provide government issued identification showing your name and current address - If you are renting, you must have the consent of your landlord to keep the animal, and have paid your pet deposit prior to adoption
- Under no circumstances are you to surrender the animal to a shelter or any other location besides PKR, without the express permission of PKR
- You must take the animal to a qualified veterinarian within 25 days of adoption, and obtain all necessary vaccinations on schedule
- Register the animal's microchip with your owner information within 24 hours of adoption
- Agree to send follow-up reports on animal well-being when requested by PKR within 24 hours of the request
- Agree to a high-quality diet for your new pet that has been approved by PKR

Questions on this questionnaire are created based on research and common reasons for animal neglect or adoption returns. Please answer these questions with detail and honesty. All information received from our questionnaires is used for screening purposes only.

Adopter Info

Today's Date * +

Is this pet(s) a gift? *

Please explain in more detail on whom this pet will be gifted to. *

First Name *

Last Name *

Street Address *

Apartment/Unit Number

City and State *

Zip Code *

Date of Birth *

Email Address *

Primary Phone Number *

Alternate Phone Number *

What is your current occupation? *

Do you rent or own? *

If you rent, do you have permission for this pet? *

Landlord's Name *

Landlord's Best Contact Number *

Do you have a significant other? *

Yes

No

Significant other's First and Last Name *

What is your significant other's current occupation? *

What part will he/she have in caring for this pet? * 🛈

Do you have a roommate? *

Yes

No

Is your roommate okay with you adopting a pet? *

Yes

No

Roommate First and Last Name *

What part will he/she have in caring for this pet? * 🛈

What will happen to your pet if your partner or roommate is allergic? *

Do you have children? *

Yes

No

How many children do you have, and what ages? * 🛈

What are their experience with animals? How do they handle animals and interact? Please describe how you will monitor the children with the cat. *

When it comes to your children and family, are there any circumstances that would make you consider surrendering this (or any) animal? *

If you or your partner/future partner were to adopt/have a child in the future, are you committed to keeping this animal as part of your family? Under what circumstances would you consider surrendering this (or any) animal? *

Please list at least two character references (who are NOT current or former family members or your significant other) with name, phone number, and email.
*This information is used for screening purposes only. We will only call your character references if we mutually decide to proceed with the adoption. The standard practice is for us to contact two references. We will provide notice before this happens.*

Character Reference #1

First & Last Name *

Best Phone Number: *

Email: *

How do you know this reference? *

Character Reference #2

First & Last Name *

Best Phone Number: *

Email: *

How do you know this reference? *

Character Reference #3 (The third reference will only be contacted in the event that an additional reference is needed)

First & Last Name *

Best Phone Number: *

Email: *

How do you know this reference? *

Current and Past Pets

Do you currently own pets? *

Yes

No

Please list current pets. Include age, gender, and breed. *

Please list any pets who are not fixed or vaccinated. *

Current Vet's Clinic Name *

Animal Clinic's Number *

Have you ever adopted from a rescue before? *

Yes

No

What rescue did you adopt from, what kind of animal(s) did you adopt, and when did you adopt? *

Please list past pets and where they currently are. If passed away, how? (past 10 years) *

Have you ever given up/rehomed a pet? *

Yes

No

If you have rehomed a pet, please explain why. *

Have you ever declawed a pet before? *

Yes

No

If yes, please explain why. *

New Pet

If you have a specific pet(s) in mind, what pet are you interested in?
*

What are you looking for in a pet? *Please list energy level, behavior, etc. *

What age range do you prefer? (Please check all that apply) *

Kittens tend to have a lot of energy. We suggest considering a pair when adopting a kitten to help redirect their energy and wrestling needs to their other cat friend. Although this is not a requirement to adopt.

If you are committing to adopt a kitten, please understand that as kittens grow and start their teenage phase, they become more agile and rambunctious. They will get into everything and will have a lot energy. It is a lot of responsibility. Are you ready for this type of commitment?

*

Yes, I'm ready for lots of energy!

No, I would like to consider a older kitten or young adult.

Would you be open to considering a cat pair? *

Yes

No

Where will your pet be primarily kept? *

Indoor

Outdoor

Indoor/Outdoor

Will your pet ever have access to the outdoors? *

Yes

No

Please explain what kind of access your pet will have to the outdoors? *

Please explain what indoor/outdoors means to you? What kind of access will your pet have to the outdoors? *

Do you currently have a dog door installed in your home? *

Yes

No

If yes, please describe the door in as much detail as possible. Is it a standard push open door, magnetic, microchip controlled, etc. *

Where will your pet be kept when you are away from home? *

Where will your pet sleep at night? *

What are unacceptable behaviors of your new pet? *

How will you resolve this behavior? *

How do you plan to introduce your new pet to your current pets?

What would happen if your new pet bit your child? *

On average per day, how many hours will you be away from your pet? *

What amount would you spend on emergency care for your pet? *

What will happen to your pet if you cannot keep it? *

What will happen if you have a career change? (traveling more, working more) *

Where would your pet go if you and your significant other were to separate? *

What will happen to your pet if you move to a different city within the state? *

What will happen to your pet if you move out of state? *

If something was to happen to you, what plan would you have for the care of your pet to avoid them going into a shelter? * 🛈

Do you plan to declaw your new cat(s)? *

If yes, why? *

We recommend purchasing items (if you do not already have them) to entertain your pet while you are away as well as supplies to ensure that they have a happy and healthy life.

Please check all the items you are willing to provide. *

What brand of food do you plan to feed your new pet?

Please specify brand and type. *

Please list any other remarks or concerns we should consider. *

How did you hear about Pawsitve Karma Rescue? *

If referred by someone, what is their first and last name? *

Other: *

By signing below you are agreeing that all the information in this questionnaire is completely accurate to the best of your knowledge. Please type your name below and date, this will act as your signature.

E Signature of Adopter *

Thank you for considering a rescue!