Application For Prospective Pet Owners

Adoption Application

Murrayhill Veterinary Hospital considers pet ownership a serious responsibility and is committed to finding our foster animals permanent, loving homes. We want to ensure that everyone who adopts an animal is aware of the responsibility and commitment that a pet requires. This application will aid us in making the best placement possible for both you and the animal.

Animal Desired	Date


Name	Home Number

Address	Work Number



Email Address


Do you Own? Rent? Live with parents or relatives?
If renting, Landlord's Name	Landlord's Number


How much money do you expect to spend yearly on a pet that you adopt?

List below the pets that you currently own:

Type of animal/breed	Sex	OVH? or Neutered?	Age	Indoors or Outdoors?	Current on Vaccinations?
1.
2.
3.

Previous/current veterinarian	Phone number

Please list the type and breed of pets that you have previously owned in the last 10 years:
Type of animal/breed	Age	How long owned?	What happened to him or her?
1.
2.
3.

Do you plan to OVH or neuter the pet you adopt? Yes No

The pet will be: Indoors Only In/Out Outdoors Only

Where will the pet be kept during the day? During the night?

I certify that all of the above information is true. I also understand that giving false information in this application is grounds for denying my application. This application remains the property of Murrayhill Veterinary Hospital.

Applicant Name: Driver's License/ID #

This form can be printed and mailed, or dubmitted during our regular business hours.

14831 S.W. Teal Blvd., Beaverton, OR 97007
Phone: (503) 579-3300 Fax: (503) 579-4645

open mon-thu: 7:30am-8pm, fri-sat: 7:30am-6pm, sun: closed
early morning admit. appt. at 7:00am mon-thu