CAHS Pet Adoption Application

CAHS Pet Adoption Application
Adopt a Rescued Animal Today

Circle Area Humane Society P.O. Box 784 Circleville, Ohio 43113
Before the adoption form will open, you must read and acknowledge the Circle Area Humane Society Adoption Agreement:

I understand and agree that the animal being adopted is the property of CAHS until every step of the adoption process is complete and the adoption fee is paid. I understand and agree the animal being adopted is for myself and will not be sold, adopted or given to another party. If circumstances arise that determine this animal must be given up, I hold the obligaion to contact and return to CAHS. I understand and agree that at any point I cannot keep the animal, I will return him/her to CAHS, and forfeit the adoption fee.

I understand and agree that the animal being adopted is a "rescued" animal and that while CAHS makes every effort to place only healthy and sound animals, CAHS cannot guarantee the animal's:

Health, Previous care or treatment (before being rescued).

I understand and agree that CAHS shall not be held responsible for any future expenses which may be incurred. Including, but not limited to, medical care, temperament issues, housebreaking issues, damaged property, or medical care for injury to persons or other animals the adopted animal may come in contact with.

I understand and agree that the animal shall not be allowed outdoors without proper supervision. When taking the animal outdoors, the animal must be kept inside a fence or on a secure harness at all times.

I understand and agree that the animal must always wear proper ID (dog tags), and that it is my responsibility to purchase these for the animal upon completion of adoption and at the first of the year and every year to follow.

I understand and agree that upon adoption this animal remains as an indoor pet only and may not live outdoors.

I understand and agree to care for the animal in a humane manner and be a responsible animal owner. This includes, but not limited to, keeping the animal safe and secure, providing fresh food and water, supplying warm and dry shelter, adequate medical care, daily exercise and constant love, affection, and attention.

I understand and agree the animal is adopted "as-is", and I assume all responsibility for the treatment of any existing conditions.

I give CAHS permission to call or visit my home at any reasonable time to assure that the animal is being cared for and treated properly.

I agree to keep CAHS informed of my current address and phone number at all times.

I agree to keep the animal up to date on all vaccinations, to give the animal monthly heartworm and flea/tick preventative, and to provide documentation of above treatment when requested.

I understand and agree the adopted animal will be seized by CAHS Rescue at any point if this agreement is violated or if the animal is found to be in any danger.　

CIRCLE AREA HUMANE SOCIETY (CAHS) RESCUE WILL NOT REFUND ADOPTION FEES IF THE ANIMAL IS RETURNED OR SEIZED DUE TO VIOLATING THIS AGREEMENT IN ANY WAY.

THIS IS A LEGALLY BINDING CONTRACT.

I AGREE ALL THE STATEMENTS I HAVE MADE ON THIS FORM ARE TRUE. IF IT IS FOUND THAT ANY STATEMENTS I HAVE MADE ON THIS FORM ARE NOT TRUE, THE ADOPTED ANIMAL CAN BE CONFISCATED.

About You
Which animal are you interested in?*
Name*

First NameLast Name
I am 22 years old or older:*

YesNo

Thank you for your interest. We do not currently adopt to applicants under the age of 22.

Your Age*
Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Place of Employment*
Date of Birth*

MonthDayYear

Housing
Housing *
Landlord's Name & Phone Number
If you rent, does your rental agreement allow pets?
Attach Pet Addendum to your Rental Agreement if available here (This will speed up the background process)

Browse Files

Cancelof
How long have you lived at your current address?*
If less than 5 years please provide previous address.

Street Address

Street Address Line 2

CityState

Zip Code
Is your property fenced?
Type of fence?
List all people living in your household.*
(First and last name) including age and relationship
Does anyone in the household have allergies?*
Does anyone in the household have asthma?*
Has anyone in the household been convicted of a felony or on probation?*
Is this companion animal a gift? *
Who will primarily be responsible of this animal's care?*
How many hours a day will this animal be left alone?*
If this is a cat, do you plan to declaw the companion animal?*

YesNo
Will this companion animal be allowed outside unsupervised? *
Where will the companion animal stay when you are home?*
Where will the companion animal stay when you are not home?*
Where will your companion animal sleep?*
Where will your companion animal stay when you are on vacation?*
What will you do with your companion animal if you move?*
Your companion animal may live fifteen plus years. Are you truly ready for that commitment? *
Why do you want a pet?*
Have you had pets before?*

Vet Information
Are your dogs licenced?*
Have you placed, lost or euthanized any animals in the past five years?*
Have you ever had a pet hit by a car?*
Name of veterinarian.*
Where your pets records can be found.
May we contact them and obtain records?*

YesNo
Veterinarians telephone number*

Area CodePhone Number
If your pets records can not be found under your name or cannot be obtained, then we will not consider your application.
Do you have any pets at this time?*
Are your pets current on vaccinations?*
Has your pet(s) had an annual checkup in the last year?*
Are you prepared to invest money in this companion animal?*
If your pet becomes sick or injured are you financially able to spend $100 to $500 or more for veterinary care?*
Name of Referral
How Did You Hear About Us?

Volunteer ReferralFriend ReferralFacebookInstagramTikTokOther
Your signature authorizes Circle Area Humane Society to verify all information provided to us on this application. In order for us to do so there will be at least a 24 to 48 hour waiting period before you will be able to take your companion animal home. This is to ensure that these animals are being placed correctly in good homes. Please realize an inaccurate or incomplete application is reason for refusal. Circle Area Humane Society has the right to refuse any application. If your pet(s) are not current on vaccines or had a current check up your application will not be considered. Circle Area Humane Society will not adopt out any companion animal that will be kept outside.
I have read and fully understand CAHS' adoption policy and further that CAHS reserves the right to refuse any application. Please initial below.*

We are a nonprofit organization with a volunteer staff. We do not receive tax dollars of any kind. We rely on donations and volunteers to keep our shelter running. We take pride in a clean facility and the fact that our animals are tame, friendly and healthy. We are separate from the Pickaway County Dog Shelter. We deal mostly with cats and the dog shelter deals with only dogs. Sometimes we will have dogs from cruelty cases, meaning they have been abused, neglected, or abandoned.

Circle Area Humane Society, is also the only animal welfare group actively fighting for proper legal rights and legislation regarding the animals of Pickaway County.

Please Note:

We here at CAHS are all volunteers, meaning that we have full time jobs, families, pets and foster animals of our own. While we do our best to make the process of connecting you with a new best friend as expedient as possible, please exercise understanding during this time. Realize it can take up to one full week for application review.

Thank you for your understanding.

Signature
Your digital signature is required to complete the online application. Please sign within the provided space. This legaly binding signature states you submitted this form of your own free will with the intent to adopt a companion animal from the CAHS facility given the afformention guidelines and policies.
Should be Empty:

CAHS Pet Adoption Application

Adopt a Rescued Animal Today

About You

Housing

Pet History for the last five years.

Pet history for the last five years:

Pet #2

Pet #3

Pet #4

Optional Additional Pet History

Vet Information

If your pets records can not be found under your name or cannot be obtained, then we will not consider your application.