United Hope for Animals

Acknowledgement (required)*

I have checked that this animal is in foster with UHA
This animal is at the shelter
I don't know the status of this animal

If your animal is at the shelter

UHA does not house any animals except those in foster. Please call the shelter at (626) 962-3577 or visit in person at 4275 Elton St, Baldwin Park, CA 91706 to ensure your animal is available.

This Application is for a

Dog
Cat

Name of Dog/Cat you are Interested in:

Applicant Information

Your Name:*

First Last

Age*

Name of Spouse or Partner:

First Last

Name of Roomate(s) (if applicable)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Phone*

Alternate Phone

Email

Occupation

Spouse or Partner Occupation

Work Schedule

Spouse or Partner Work Schedule

Names of all Persons Living in Your Household, Their Relationship to You, and their ages:

Please tell is a little bit about yourself and why you want to adopt

Does EVERYONE in your family want to adopt?

Yes
No

Please name a personal reference and his/her relationship to you:

Relationship

Phone

Home

Type of Dwelling

Home
Condo
Apartment

Rent or Own

I own my home
I rent my home/apt
I live in Military housing

If you live in a condo or apartment, what are the association's rules about pets?

Do you have the landlord's permission to have a pet?

yes
no

Landlord's name and phone number

Your home has

1 story
2 stories
3 stories

If adopting a dog, do you have a pool?

yes
no

If you have a pool, is it fenced?

yes
no

How do you introduce a dog to a pool?

Would you object to an inspection of your home by a rescue volunteer?

yes
no

Your Companion Animals

Do you have the financial means to spend hundreds or even a few thousands of dollars on veterinary care for your pet should the need arise?

yes
no

Do you currently have a cat?

yes
no

Name and Breed of Current Cat(s)

Age of Current Cat

How long have you had the cat?

Do you presently have a dog?

yes
no

Name & Breed of Current Dog

Age of Current Dog

How long have you had a dog?

Sex Altered?

Yes
No

How and Why Obtained?

Have you had dogs prior to your current dog?

yes
no

Have you had cats previously?

yes
no

Breed of Previous Cat

Sex Altered on Previous Cat?

yes
no

History of Previous Cat

Additional Details for Previous Cat

Breed of Previous Dog

Age of Previous Dog

Sex Altered on previous dog?

yes
no

History of Previous Dog

Additional Details for previous dog(s)

Have any of you dogs/cats every had puppies/kittens?

yes
no

If yes, bred for (check all that apply)

fun
profit
show
accident

Has any member of your family every experienced animal-related allergies?

yes
no

Have you ever trained a dog in obedience class?

yes
no

Do you have other pets?

yes
no

How many other pets do you have?

What species?

Where do you keep these other pet(s)?

How long have you had these pets?

If you have a cat, is it declawed?

yes
no

Please include the name and contact details for your veterinarian

Who would be responsible for your pet's care?

What is your primary reason for adopting?

Where will your new dog or cat sleep?

How many hours/day will your new dog or cat be left alone?

Where will the dog/cat be left when you are away from home?

indoors
outdoors
other

If outdoors:

in the yard
on the patio
in a kennel
in the garage

if other, where?

Do you have a pet door?

yes
no

If a yard, is it fenced and how high is the fence?

Please indicate if the fence if wood, chainlink or another material:

Have/would you use a pet-sitter or pet daycare center?

yes
no

When home, pet will be:

always indoors
mostly Indoors
always outdoors
mostly outdoors

Please upload a photograph of the area where your pet would sleep (jpeg or gif files only)

This can also be emailed to us later if you don't have a photo right now. Please keep file sizes under 1MB if possible.

If pet will be outside at all, what outside space if available?

garage
dog run
fenced yard
unfenced yard
patio
balcony
other

if other, please describe:

Please upload a photo of your yard (jpeg or gif only please)

This may be emailed to us at a later date and is not required to complete this application. Please keep file sizes under 1MB if possible.

How do you plan to handle the pet's exercise needs?

Do you travel a great deal?

yes
no

If yes, how often and how long at a time?

When you travel, how do you intend to provide for the pet while you are gone?

If a pet became destructive to your home, what would you do?

Do you have any "musts" for a pet to be able to fit into your life?

Do you feel obedience training makes a dog a better companion?

yes
no

If necessary, are you willing to attend obedience classes at your expense?

yes
no

Under what circumstances would you not keep the dog or cat? (check all that apply)

please explain:

What provisions would you make for your pet if you had to move?

What would you do if the dog grew bigger than expected?

return to the rescue
take to the shelter
keep outside
be glad there is more to love!

Is there anything else you would like to tell us about yourself or your home environment?

Digital Signature*

To sign with your digital signature, please enter your birth month in the box above.

Name

This field is for validation purposes and should be left unchanged.

Advocating for Homeless Pets in Southern California

Adoption Application

Adoption Application for Animals in UHA Foster

If your animal is at the shelter

Applicant Information

Home

Your Companion Animals