The Animal Health Center of Hays, IIc 
A Lifetime of Care for Your Animal Friends

If you are interested in one of our many adoptable pets, please fill out our adoption application.  Be sure to include the name of the animal you are interested in.

*Name
*Address
*City, State
*Zip Code
*Phone number
*Name of Animal
*Do you own or rent?
*Length of time at current address?
*If you rent, will your landlord allow you to have a pet?
*Name and phone number of landlord
*How much time will this animal be inside?
*How much time will this animal be outside?
*Do you have a fenced yard? (not applicable for cats)
*Do you have other pets? (Type and age)
*Name of number of your veterinarian for a reference.
*Have you ever surrendered a pet to a shelter and if so, for what reason?
*Is this your first pet?
*How do you plan on disciplining your pet?
*What will you do with your pet if you have to move?
*Have you researched this breed?
*Place and length of employment?
*What would you estimate to be the yearly cost of caring for this animal?
*By signing below, I affirm that the above answers are true and correct and acknowledge that the staff of Western Plains Veterinary Refuge will verify the information provided.
*Date
Verification Code :
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