All pets under your care must have a current Rabies Vaccination given by a veterinarian & acurrent Tag.
(Unless your veterinarian has given you a written waiver for your records)
(Unless your veterinarian has given you a written waiver for your records)
Date of most recent Rabies Vaccination & Date of Tag Renewal for each pet in home:
Pet #1 Rabies Vaccination
Tag Date
Pet #2 Rabies Vaccination
Tag Date
Pet #3 Rabies Vaccination
Tag Date
Veterinarian’s Name
Telephone
Are all of your animals spayed/neutered? Yes No
If no, why not?
What type of home do you live in? Apartment/Rent
Townhouse/Rent Condo/Rent Rent Single Family Home
Own Home Own Townhouse Own Condo If you rent, does your landlord allow pets? Yes NoHave you confirmed if there are any breed/species restrictions? Yes No
Townhouse/Rent Condo/Rent Rent Single Family Home
Own Home Own Townhouse Own Condo If you rent, does your landlord allow pets? Yes NoHave you confirmed if there are any breed/species restrictions? Yes No
Do you have authorization from your landlord to have a pet? Yes No
If applicable, name of landlord and phone number?
IF RENTAL, IS PET DEPOSIT PAID? Yes No Date of payment: