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Muffin's Adoption Questionnaire
If you are interested in adopting one of our dogs or cats, please fill out the form below and then click the submit button.
Name
Address
City State Zip
Your email address
Home Phone (include area code)
Work Phone (include area code)
Fax Phone (include area code)
Sex: Male Female
Are you over 21? Yes No
Do you work? Yes No
What is your occupation?
Does your spouse (if applicable) agree to the adoption? Yes No
Is the adoption for yourself? Yes No
Do you rent? Yes No
If so, do you have Landlord permission? Yes No
Can you afford the adoption fee? Yes No
Do you have any allergies/asthma? Yes No
Which pet are you interested in? Cat Dog
What is the pet's name that you are interested in? Do you have screens on all the windows? Yes No Will the cat be indoors? Yes No Do you have a fenced yard?Yes No If Yes, How high? Do you have any other pets?Yes No
If yes, describe them:
Are they spayed/neutered?Yes No
If not, why not?
Veterinarian's Name
Vet's Phone Number
Do you have children?Yes No If so, what are their ages?
How much time will this pet spend alone?
Who referred you to Muffins?
Date:
Thank you, Jude Muffin's, Director
