Adoption Application: Vet Reference

Adopter name

Name of vet clinic

When did the applicant first start coming to you?

Are all of the applicant’s animals (dogs and cats) current with all recommended vaccinations?

Dogs only: If the above answer is no, when was the last visit you have on record and which vaccines are not current? (The family may use titer testing rather than annual vaccines. If that is the case, ask when this titer testing was done last.)

Dogs only: Does the applicant test for Heartworm once a year?

MLRR Volunteers: If the dog is not up-to-date on vaccines and/or is not receiving annual heartworm testing, please stop here and contact Kim

Dogs only: Does the applicant give heartworm prevention to their dogs every month?

Does the applicant always provide the necessary medical attention that the dog and/or cat requires to keep them in proper health?

Are all animals in the home spayed and neutered?

Do you have any concerns or reservations about the care the applicant has given to their pets?

Additional Comments