You are always welcome to meet our adoptable pets. Complete our survey so our adoption counselors can help you find a perfect match. Surveys may also be filled out in person at our adoption center.
First Name*
Last Name*
Your age group* 18-2021-3535-55Over 55
Your Email*
Your Phone Number*
Best time of day to be reached?* --Select Option--MorningMiddayAfternoonEvening
Street Address*
City*
State*
ZIP code*
Is Your Mailing Address the Same as Your Current Address? YesNo
Mailing Address*
What kind of pet are you interested in adopting?* --Select Option--Cat AdoptionDog AdoptionCat & Dog AdoptionRabbit AdoptionGuinea Pig
What is your ideal pet like? (couch potato, jogging buddy, family pet, etc.)
Do you have an animal?* YesNo
Do you have one or more dogs? Ages, breeds, sizes?*
Do you have one or more cats? Ages?*
Do you own or rent?* If you rent, please secure permission from your landlord in advance. We cannot hold a pet while you obtain permission. Sadly many people do not return to adopt because they don’t have permission and the pets are held longer, waiting for a new adopter to take them home. We must have your rental agreement that states pets are allowed or a phone number we can call to speak with your landlord. OwnRent
Tell us about members of the new pet's household (e.g. # of adults/seniors/young children)
Do you have a veterinarian? I have a VeterinarianI do not have a VeterinarianI would like more info on SCAS's Veterinary Hospitals
Extra services and opportunities (check any you are interested in) Low cost vaccination program for any current petsLow cost spay/neuter services and full service veterinary hospitalsVolunteering or Fostering with usSupporting us with financial or in-kind donationsOur training classes
Under what circumstances would you consider returning your pet?
Anything else you want to tell us?
How did you find this pet? Second Chance WebsitePetfinderAdopt a PetPrevious AdopterFacebookTwitterOther
Our Senior & Veteran Companion Program offers a $25 discount to adopters age 65 and over and to our veterans. To get this discount, please show proof of age or your veteran ID at the time of adoption. We are unable to apply this discount retroactively so please be sure to show your ID while your adoption is being finalized. ($25 maximum discount may be applied through this program.) I qualify for the Senior or Veteran discount and will provide my ID at the time of adoption.I qualify for the Senior or Veteran discount, but please keep the $25 discount to help another homeless pet.I do not qualify for the Senior or Veteran discount.
Please note: the survey is not intended to hold a particular pet. Our goal is to give each pet a ‘Second Chance’ as soon as possible so we cannot place a hold on a pet until you have met them. 24-hour holds are strictly to ensure each family member has met the pet prior to adoption to ensure the best match.* I understand
I attest I am over 18 years old
My signature below certifies that all information listed on this survey is true and complete. Please type your full name to sign:
