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Adoption Application
You will receive a copy of your application by email.
First Name Home Phone
Last Name Cell Phone
Address Work Phone
Address 2 Email
City
State / Zip
 
We are glad you are considering adopting a new pet through HSSET. The following information is requested so that your adoption counselor may assist you in the selection of a new pet. The consultation process is designed to help us determine if the adoption is in the animal's best interest and to assist you in finding an animal most compatible with your lifestyle.
To Be Considered A Potential Adopter, You Must:
  • Be 18 years of age or older;
  • Have identification showing your present address;
  • Have the knowledge and consent of your landlord and can be reached by our staff prior to adoption;
  • Be able and willing to spend the time and money necessary to provide vaccinations, medical treatment, training and proper care for a pet;
  • Agree not to chain the animal outdoors;
  • Not be adopting an animal for a Gift or on behalf of someone else;
  • Not have had an animal who has died of any contagious disease within the last 6 weeks;
  • Return the animal to Humane Society of Southeast Texas, if, for any reason, you are unable to keep;
  • Consent to a home visit, with prior notice at a mutually agreed upon day and time:
If You Meet The Above Qualifications, Please Complete The Following:
I am interested in adopting a:
I would like to adopt a:
Name(s) of the animals you are interested in adopting:
Why are you interested in this/these particular Pet(s)?
Is this your first experience with a pet?
Please check any of the following reasons you wish to adopt a pet:
If other reason for adoption specify your reasons here:
When home alone, the animal will be:
When Other provisions or size of enclosure:
Do you own any pets at the present time?
If yes, please list the following:
Name, Breed, Age, Sterilized, Declawed, Inside or outside
If How many dogs or cats have you owned in the past 5 years?
Dogs Cats
What other pets have you owned in the past 5 years?
What happened to those pets?
(Be specific, include name, breed, ages, health, died of old age, fatal disease, sterilized, hit by a car, stolen, disappeared?)
Have you ever given up an animal?
If yes, please state reason:
Who is your veterinarian?
What is your veterinarian's phone number?
May we call your veterinarian for a reference?
Do you currently reside in a:
Do you own or rent
If you rent, does your lease allow pets?
*** Please note: must have landlord approval PRIOR to leaving the shelter with your new pet. ***
If you rent, what is your Landlord's Name:
If you rent, what is your Landlord's Phone:
How long have you lived at the above address?  
How many people live in your household?   
Do all the adults know that you plan to adopt?
If there are children in the household, what are their ages?
Is anyone in your household allergic to animals?
Is your new pet going to be an indoor or outdoor pet?
What type of preventative do you use for fleas?
Are you aware of Heartworm Disease and will you ensure your pet is protected monthly?
What type of preventative do you use for heartworms?
Do you have a dog-door?
Is your yard fully fenced?
How high is the fence?      feet
What will you do with this pet if you move?
What will you do if you become financially/physically unable to care for the animal?
How did you hear about HSSET and/or this Pet Adoptathon?
By my action of submitting this form I certify that the above information is correct and clearly understand that providing false information can result in the Forfeiture of the adopted pet.
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