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Humane Society of Pagosa Springs
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PRE-ADOPTION QUESTIONNAIRE
OUR ADOPTION PROCESS AND WHY WE DO IT THIS WAY
Please take a few moments to read the following explanation of our adoption policies and the steps that make up the process. You may be surprised that adopting an animal is a more involved process than you expected. The process is the same for everyone. It is not our intent to frustrate you. Everything we do is for the best interests of the animals in our care, and it is aimed at giving them the best possible chance of finding a permanent home. Please bear with us and be patient.

Here are the steps you will go through in the adoption process:
  1. You will be asked to sign an adoption contract and to pay an adoption fee. The adoption fee covers a spay/neuter surgery, all initial shots except rabies (must be administered by a licensed veterinarian in the state of Colorado), micro-chipping AND your registration, and a basic health examination (provided by a participating local veterinarian of your choice). All adopted animals must be spayed or neutered prior to going home.
  2. For any animal adoption, we will verify veterinary and/or personal references. For those who rent, we will verify a landlord's permission to have a pet(s). For canine adoptions, we require a home visit to be conducted. If you have had a previous home visit, another may be conducted depending on your current circumstances. For feline adoptions, a home visit is discretionary. You must agree to allow an agent of HSPS to visit your home prior to taking an animal home. The entire process typically takes from 1 to 4 days.
  3. At any point in the process, during or after, feel free to ask any questions you might have about bringing a new animal into your home.
Fill out form and submit online or print the following report form and mail to the Humane Society Animal Shelter at 465 Cloman Blvd., PO Box 2230, Pagosa Springs, CO 81147 or fax to (970)731-5552.

Date:         Are you interested in adopting a: Dog  Cat

Animal's Name(s) you are interested In:

You (& your Spouse's) Name(s):

Physical Address:
City: State: Zip:

Mailing Address:
City: State: Zip:

Email Address:

Primary Phone:    Home  Cell  Business

Secondary Phone:    Home  Cell  Business

DL State & #:   Exp Date:   DOB:

House    Apartment    Other:     Own  Rent

If you rent, provide name and phone number of landlord:

Every potential adopter is required to completely fill out this form before being considered for a pet. This information will help us to make the adoption experience a good one for you and for the animal.
The Humane Society of Pagosa Springs reserves the right to refuse any adoption.

List other pets you currently own:
              Dog or Cat - Name - Breed - Age - M/F - Spayed/Neutered (S/N) - Time Owned
List up to four pets you have owned in the past 5 years, but no longer have:
              Dog or Cat - Name - Age - M/F - Spayed/Neutered (S/N) - Time Owned - Reason No Longer At Home
Who is/was your Veterinarian?   Phone:

Is everyone in your household aware that you are adopting a pet? Yes  No - If not, please explain:


Is anyone in your household allergic to animals?

Number of children in your household and their ages: - - - -

Will this animal be given as a gift? Yes  No

Do you plan to care for this animal for its lifetime? Yes   No

Who will be the primary care-giver providing food/water/training/veterinary care?

Will you keep this pet: Indoor  Outdoor  Indoor/Outdoor

If the pet will be kept primarily outdoors, will it be: Chained   Fenced  Unrestrained

What type of shelter will be provided?

How many hours a day will the pet be left alone?

Will you have your pet routinely vaccinated for rabies and other pet diseases? Yes  No

If you move, will you take the pet with you? Yes  No

List 3 references with phone numbers (ONE RELATIVE ONLY PLEASE):
I verify that I have answered the above questions truthfully and accurately. I agree to allow an agent of the Humane Society of Pagosa Springs (HSPS), or their representative, access to my property at any time for pre-adoption AND post-adoption visits. I agree to allow an agent of the HSPS to remove from my premises any animal or animals adopted from HSPS if information I have provided is found to be false, or if my home or the animal(s) is deemed unsuitable.

Signed:   Date:

(Select Submit to send completed questionnaire to Humane Society Animal Shelter by email.)

(Clears form.)



Animal Shelter -
Hours: Mon.-Sat. 10am-5pm, Sun. 10am-4pm
Address: 465 Cloman Blvd., PO Box 2230,
               Pagosa Springs, CO 81147 (Map)
Phone: (970)731-4771 FAX: (970)731-5552
E-mail: sheltermanager@humanesociety.biz
Thrift Store -
Hours: Mon.-Sat. 9 am-6 pm, Sun. 10 am-5 pm
Address: 279 Pagosa St on Hwy 160, PO Box 2230,
  Pagosa Springs, CO 81147 (Map)
Phone: (970)264-6424 FAX: (970)264-5593
E-mail: hsthriftstore@humanesociety.biz
Administrative Office -
Hours: Mon.-Fri. 8am-5pm
Address: 279 Pagosa St on Hwy 160, PO Box 2230,
  Pagosa Springs, CO 81147 (Map)
Phone: (970)264-5549 FAX: (970)264-5593
E-mail: hsadmin@humanesociety.biz