Orange County Animal Services
CAT Adoption Application
Last Name:
First Name:
PID:
Address:
Apt.:
City:
State:
Zip:
Subdivision/ Apartment Complex Name:
Is this the address where the cat will live?
Do You:
Own your home
Yes
✔
No
Rent
Home Phone:
Reside with parent(s)
Work/Cellular Phone:
Additional contact name and phone:
E-mail address:
How many children in household and what are their ages?
Yes
Is anyone in your household allergic to animals?
No
What breeds of animals do you currently own and how many? Do any of them have known health conditions?
Are they vaccinated? Yes
No
Are they spayed/neutered? Yes
No
What is your reason for adopting this particular cat?
Where will your new cat spend most of his/her time?
indoors
outdoors
both
Animal Services has no history on animals prior to entering the shelter. Basic health assessments are performed on
all animals before adoption and every attempt is made to adopt out a healthy pet. Are you able to keep your new pet
separated from all existing pets for a minimum of seven (7) days? Yes No
Check any of the following reasons you would give your cat away, if applicable:
Fleas ................................
Allergies .........................
Too expensive ................
Having a baby ................
Shed too much fur .........
Getting married or divorced
Chews or destroys household objects
Family member will no longer take care of it
Found a new place to live and they don't allow pets
Urinates or defecates outside of the litter box
Have you adopted a pet from Orange County Animal Services in the past 12 months?
Orange County Animal Services
CAT Adoption Application
_______(Intls) 1.
Applicant must be at least 18 years of age.
_______(Intls) 2.
All adoption animals will be spayed or neutered before leaving the shelter.
_______(Intls) 3.
Animals adopted prior to three (3) months of age must be returned to Orange County Animal
Services for a rabies vaccination at three (3) months of age.
_______(Intls) 4.
Any deposits required by your landlord must be paid prior to your adoption application
being approved, unless otherwise specified by your landlord.
_______(Intls) 5.
Orange County Animal Services makes no claims regarding the behavior or temperament of
animals placed for adoption. Animals should never be left unsupervised with children.
_______(Intls) 6.
Animal Services has no history on animals prior to entering the shelter. Health assessments
are performed on all animals before adoption and every attempt is made to adopt out a healthy pet.
_______(Intls) 7.
of seven (7) days.
It is your responsibility to keep your new pet separated from all existing pets for a minimum
_______(Intls) 8.
During the first ten (10) days of ownership, a licensed veterinarian should examine your new
pet. If any medical problems are discovered, you may return the pet. At that time you may choose another pet or
apply for a refund of your initial adoption fee. You must provide the division with a copy of your veterinarian’s
diagnosis and your adoption receipt. Animal Services will not be responsible for reimbursement of any medical bills.
Upon possession, I will accept responsibility for the animal identified by:
Cage:________________________ ID: A_________________________( Do Not put ID # until approved at our shelter.)
I hereby release and waive from liability or responsibility Orange County Animal Services, Orange County,
and/or any employees thereof, in the event that any damages to person or property are caused either directly
or indirectly by an adopted animal. All adoption refunds may take up to eight (8) weeks to process. I swear
or affirm that I have answered the questions on this application truthfully and correct to the best of my
knowledge and belief, and that I have read, understand, and agree to its contents.
Signature:
Date:
Identification received:
Date of birth:
DIVISION USE ONLY
Prior check:
By:
Yes / No Activity:
Out of County Animal Services Contacted:
Landlord Contacted - Date:
By:
Yes / No Deposit:
Amount $
Pet Limit: __________________ Pet Restrictions:
Approved:
Denied:
By:
Copy Given: Yes / No