Request to Rehome My Pet

Today's Date*

Owner’s Legal Name (first and last)*

First Last

Primary Phone Number*

Email Address*

What city do you live in?*

Do you wish to rehome a*

Cat or kitten
Dog or puppy

Did you adopt this pet from Fayette Humane Society?*

Yes
No

If yes: What was its name when it was in our system (when you adopted it from FHS)?

Pet's Name*

Breed*

Color*

Age*

Why do you need to rehome your pet (describe fully)?*

IMPORTANT- Please Check*

I will send pictures of my pet I wish to rehome to info@fayettehumane.org.

Is your pet spayed or neutered?*

Yes
No
I don't know

When was the last time your pet went to the veterinarian?*

Is your pet up to date on shots (vaccines)?*

Yes
No
I don't know

Is your pet currently on heartworm prevention?*

Yes
No
I don't know

When was the last time your pet had a heartworm test?

Does your pet have any health issues?*

Yes
No
I don't know

If yes, please fully describe and explain how they are managed?

IMPORTANT- Please Check*

Send copies of any vet records (okay to take pictures of them with your phone) to info@fayettehumane.org.

How is your pet around children?*

How is your pet around cats?*

How is your pet around dogs?*

Does your pet have any behavior issues?*

Yes
No

If yes, please provide full description and things you have tried to resolve the issues:

Has your pet ever bitten a human within the last year?*

Yes
No

If yes, please describe the situation in as much detail as possible.

If your wish to rehome your dog, has your dog ever bitten another dog?*

Yes
No

If yes, please describe the situation in as much detail as possible.

Please use the space below to write anything else you feel we should know about your pet or your situations.

Confirm*

By checking this box and typing my name in the space below (digital signature), I am agree that I have read and completed this application fully and to the best of my knowledge and that all information I have provided is truthful and accurate. *

I confirm.

Digital Signature (Full Legal Name)*

Date*

File

Request to Rehome My Pet

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