Quincy Humane Society

Saving Pets and Their People Since 1880

Call: (217) 223-8786

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Online Adoption Questionnaire

Online Adoption Questionnaire

Thank you for choosing to adopt a pet from the Quincy Humane Society! This questionnaire will help guide additional conversation with you to ensure that this pet is the right fit for you and your family. We will spend some time discussing the adoption process during a meet and greet with the pet you are interested in.

I am interested in adopting(Required)

Name of animal of interest

Adopter #1 Full Name(Required)

Date of Birth(Required)

Adopter #1 Phone Number(Required)

Adopter Full Name #2

Date of Birth

Adopter #2 Phone Number

Email Address

Enter Email Confirm Email

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Are you currently employed?(Required)

Military Status if applicable(Required)

Do you rent or own your home?(Required)

We welcome adopters who rent, or live in an apartment or condo. We want to alert you that some landlords and management companies have size and breed restrictions, limits on the number of pets, and/or require pet deposits or additional fees.

How many adults are in the household?

How many children are in the household? Please list ages.

Do you have frequent visitors between the ages of...(Required)

0-5 years

6-12 years

13-18 years

None of the above

Tell us about any pets in the household (check all that apply)(Required)

I have one or more dog(s)

I have one or more cat(s)

I have adopted from QHS before

N/A, I am a first time pet owner

N/A, I don't have any current pets

Have your pets been seen by a veterinarian in the last year?(Required)

Please list all current pets names(Required)

Veterinary Clinic Name(Required)

Clinic Phone Number(Required)

We will explain the pet's medical and behavioral history that we are aware of. Check additional topics you'd like to discuss:(Required)

Feeding this pet

Crate training

House training/ litter box training

Pet introductions

Pulling on a leash

Pet ID options

Grooming/nail trimming

Puppy/Kitten proofing

Exercise needs

Declawing

Finding a veterinarian

Pet Insurance

Flea/Tick and Heartworm Prevention

What is the best time of day to contact you?

Please let us know your preferred way of communication(Required)

Email

Phone Call

Text

Required Acknowledgment

By my signature, I certify that the above information is complete and correct and that I am at least 18 years of age. I understand that completing this application does not guarantee I will be allowed to adopt a pet and that the application is a tool to help the Quincy Humane Society determine if this pet and my family are a good fit for each other.

Consent(Required)

I agree to the privacy policy.

By checking this box, I understand that QHS may conduct a background check. I agree to the above statement and certify that typing my name and date below equals my signature.

Adopter's #1 Signature(Required)

Adopter's #2 Signature

Date of Application Submission(Required)

MM slash DD slash YYYY

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How can you help the Quincy Humane Society?
We are in need of volunteers, household items, and donations.
Please click here to find out more about how you can help our shelter.

Hours of Operation

Monday 12:00 - 5:00
Tuesday 12:00 - 5:00
Wednesday 12:00 - 5:00
Thursday 12:00 - 5:00
Friday 12:00 - 5:00
Saturday 12:00 - 5:00
Sunday CLOSED

Phone

(217) 223-8786
Fax: (217) 223-9471

Location

1705 N. 36th St.
Quincy, IL 62305

Mailing Address

PO Box 3173
Quincy, IL 62305

© 2024 Quincy Humane Society