Please complete the following application in its entirety, and submit it to a PAHS employee for verification.
Foster Adoption Form Download
Today’s Date:
Name:
Date of Birth:
E-mail:
Phone Number:
Address:
City:
State:
Zip Code:
Human Household Members
Age
How will they be involved in care?
-additional fields
Animal Household Members
Breed
Sex
Spayed / Neutered
Date of Rabies Vaccination
Name of Vet Clinic:
Phone #:
If needed, do you have approval to have a foster pet in your home?YesNo
If you rent, does your landlord allow pets?YesNo
Describe where you will be keeping the foster animals, including how you will separate them from your own animals, if applicable:
Approximately how long, on an average day, will your foster animals be left alone in the home (without people to monitor eating, behavior and elimination)?
Previous experience with animals:
My household is able to foster: (check all thet apply)
Pregnant CatNursing Mother Cat and LitterKittens: 0-4 Weeks of AgeOlder Kittens: 4-10 Weeks of AgeAdult CatCat or Kitten recovering from injury or surgeryCat or Kitten on treatment for a coldCat or Kitten on treatment for ringwormCat or Kitten needing behavioral modification
Pregnant DogNursing Mother Dog and LitterPuppies: 0-4 Weeks of AgeOlder Puppies: 4-10 Weeks of AgeAdult DogDog or Puppies recovering from injury or surgeryDog or Puppies on treatment for a coldDog or Puppies on treatment for ringwormDog or Puppies needing behavioral modification
Anything else you would like to share about yourself or your experience?
Relation:
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