Adopt Furry, Feathered and Unique Pets Small Animal Pre-Adoption Questionnaire Name* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* How many people live in your home?* How many of them are under the age of 18?* Ages* Who will be primarily responsible for the care of the small animal?* What kind of small animal are you looking to adopt?If there is a particular pet at the shelter you are interested in adopting, please enter the name of the pet below.What kind of pet are you interested in? Rabbit Hamster Guinea Pig Ferret Other If Other, please descibe: Sex Male Female Undecided Are you looking to Adopt Foster Undecided Check 3 characteristics you find most appealing in a small animal. Active Playful Outgoing Independent Affectionate Loving Aggressive Calm Gentle Have you ever owned a small animal? Yes No If yes please explain: Where will the small animal live?*Make a selectionIndoor only (given free roam of the home)Indoor only (restricted to certain areas)Indoor and OutdoorOutdoor onlyWould like advice on thisDo you have a cage for your small animal? Yes No How often do you plan to clean the cage? What will you be feeding your small animal? The expense of owning a pet can vary greatly depending upon its individual needs and your lifestyle. To help us recommend the right pet for you, please indicate how much you can comfortably afford to spend each year:Make a selectionUnder $200$200 - $500$500 - $1000Whatever it takesIf you were no longer able to care for your pet, what plans would be made?*Current PetsPlease describe the pet(s) currently living in your home. Include their name, species/breed, and how long you have owned them.*DetailsWhat is the name and location of the animal hospital that cares for your pets?*DetailsPreviously Owned PetsDescribe the pet(s) you have owned within the past ten years. Include their name, species/breed, how long you owned them and what happened to them.*DetailsWhat is the name and location of the animal hospital that cared for your previous pets?*DetailsEnvironmentThe noise/activity level in your home is usually:Make a selectionBusy (visits from friends, parties, etc.)Noisy (TV, stereo, machinery, kids playing, etc.)Moderate (normal comings and goings)Quiet (homebodies, few guests)Do you live in a:*Make a selectionHouseApartmentCondo/CoopOtherSpecify Other Do you own or rent?* Own Rent Additional InformationHow did you find out about the Humane Society of Westchester?Make a selectionFlyer/PosterWord of mouthRadio/TVVeterinarianNewspaperInternet siteOtherVeterinarian name Newspaper name Internet site Other Δ From rabbits and guinea pigs to birds and hamsters, it’s your choice!The list below defaults to Small & Furry. Select the dropdown for more options, including rabbits. If there are no pets available in that category, nothing will display.