Safe Haven Pre-Adoption Form

The SAFE HAVEN Humane Society appreciates your concern for homeless animals. We respectfully request that you complete this Pre-Adoption Application so that we can assist you in finding a suitable companion pet. SAFE HAVEN respects and strictly adheres to the regulations set forth by the Illinois Animal Welfare Act, which specifically stipulates that any adopted animal must be spayed or neutered. A new pet must also be properly inoculated with special attention to rabies. I understand that SAFE HAVEN must approve of my ability to be an adoptive family for a SAFE HAVEN companion pet. An adopted animal must be examined by a veterinarian within 7 days following adoption.

All adoption fees will be waived for financial need

If you are 18 years of age or older and have a valid ID showing your current address, you may complete the following:

If You Rent Your Residence Please Give:

IN THE PAST 5 YEARS, tell us about the Other Pets you owned including breed, where kept, oldest age, sex, neutered, still owned and where it is now:

Potential problems such as excessive barking, chewing, digging, housebreaking, and/or aggressive behavior may require obedience classes. Are you willing to spend the time and money to correct such behavior?

Name, Address and Phone Number Of Two References

By submitting this form electronically, I hereby certify that the information I have provided is true and that any misrepresentation may result in my losing the privilege of adopting a pet from SAFE HAVEN. I authorize SAFE HAVEN to confirm any of the information I have provided and understand that SAFE HAVEN has the authority to deny a pet adoption.

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