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Every organization needs rules and regulations to operate by. The Northeast Arkansas Humane Society is no exception. Over the course of the years we have formulated policies and drawn up forms so as to avoid confusion and misunderstanding. In order to keep people informed of these policies and let them know what to expect when they visit the shelter, we are posting these policies and forms for the public's information. You may print these policies and forms, but since the forms are not on official letterhead, you will need to fill out the official forms at the shelter. However, it might be a good idea to print and fill out a form before you come so you will have the necessary information at hand when you arrive at the shelter.
Adoption Application
Adoption Agreement
Adopted Animal Information
Surrender Policy & Form
Refund/Exchange Policy & Form
Heartworm Testing Information and Policy
Policy Covering Use of NEAHS Traps
Adoption Application
1 copy for office; 1 copy for adopter
SUITABLE HOME
The Adopter agrees to provide a suitable home for the Adopted Animal. A suitable home is one that provides good wholesome food, water, shelter and protection from the weather, veterinary care, exercise, love and attention, as well as one that observes ALL STATE, LOCAL, AND CITY ANIMAL ORDINANCES, AND ANTI-CRUELTY LAWS.
TREATMENT OF ADOPTED ANIMAL
T he adopter acknowledges and agrees that the Adopted animal:
Will be treated humanely, not used for experimentation, not used for food, not used for illegal purposes (including dog fighting). If the
Adopted animal is impounded at an animal shelter, the Adopted assumes responsibility for all fines and charges to claim the animal.
SURGICAL STERILIZATION
Spay/neuter surgery of EVERY Adopted Animal is MANDATORY. Spay/neuter fees are INCLUDED in the adoption fee.
REPOSSESSION
The Adopted agrees that NEAHS has the right to request the return of the Adopted Animal if the NEAHS, at its sole discretion, determines any of the following: The adopted animal is not being kept in living conditions satisfactory to the NEAHS, it is not receiving proper veterinary care, the Adopter did not have the animal spayed/neutered as required, or the Adopter breached any terms of this contract.
STATUS OF ADOPTER
The adopted is OVER the age of 18 yrs. The Adopter acknowledges that the Adopted Animal is not being adopted to anyone other than the Adopter and/or the Adopted immediate family, and that the Adopter is and will continue to be responsible for the Adopted Animal (unless the Shelter Director approves of the special circumstances).
VACCINATIONS AND MEDICAL TREATMENT
The Adopter agrees to get ALL vaccinations within 30 days from the date of adoption for the Adopted animal and assumes the costs for these services.
HEALTH OF ADOPTED ANIMAL
The NEAHS reserves the right to withhold any guarantee if the Adopted Animal appears to have health problems at the time of adoption. If the Adopter chooses to adopt the Adopted Animal under the circumstances, the Adopter acknowledges that they will assume the costs of treating the animal.
TEMPERMENT/BEHAVIOR
The adopter understands and agrees: That animals are different from human beings in their responses to human action, that the actions of animals are often unpredictable, animals should be closely supervised when they are with children, that an animal’s behavior may change after it leaves NEAHS and accustoms itself to a home or other environment.
DISCLAIMER
The NEAHS makes no claim or representation as to the temperament, health, age or mental disposition of any animal put up for adoption.
RELEASE AND DISCHARGE
The Adopter hereby releases and discharges the NEAHS, its officers, directors, and employees from liability whatsoever from any damage to any person or property caused by said animal, and from any causes of action, claims, suits, or demands that may arise as a result of injury or damage caused by or to said animal. The Adopter hereby waives any causes of action, claims, suits or demands that Adopter, or his or her heirs, executors or assigns have or may have in the future against the NEAHS, its officers, directors, and employees for any reason whatsoever related to the adoption of the Adopted Animal, including but not limited to the repossession of the Adopted Animal in accordance with this contract. Policy and fees are subject to change without notice as amended by NEAHS Board of Directors.
REFUND EXCHANGE POLICY
IF THE ADOPTED ANIMAL BECOMES ILL, OR OTHER PROBLEMS ARE DISCOVERED WITHIN 14 DAYS OF THE ADOPTION DATE, THE NEAHS WILL OFFER EXCHANGE ONLY. THE EXCHANGE MUST BE MADE WITHIN THE 14 DAY PERIOD.
By my signature, the undersigned agrees in full to the above terms and conditions for adoption.
______________________________________________________________________ _______________________
August 2008
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Adoption Application
Many of the animals at the NEAHS have been abandoned. As a result, it is difficult to know their backgrounds before they came into the shelter. We try our very best to learn as much as we can about our animals so that we can help adopters find their "forever friend." We reserve the right to deny an adoption if we feel the animal is not a good match.
Date ______________________
FOR OFFICE USE ONLY
Paid $________ Cash Check # ________ VISA/MC AMEX/DSCV Animal Tag # _____________________
PLEASE PRINT CLEARLY
ABOUT YOU
Name_______________________________________________ _Age (if <18)______Divers Lic #_____________________________________State_____
Address_________________________________________________________________City/State_______________________________Zip____________
Home Phone #_________________________________________________Alternate Phone ___________________________________________________
Employer Name, Address/Phone # _________________________________________________________________________________________________
ABOUT WHERE YOU LIVE
If choosing a dog, do you have a fenced yard or pen? Yes________ No ________
Do you rent_______ or own _______?
If you rent, you must obtain written permission from your landlord, prior to adoption, showing that you can have a pet. Be sure to get your LANDLORD PERMISSION SLIP filled out and returned to NEAHS.
TELL US MORE
Have you had a pet before? Yes_________ No__________
Do you presently have any pets? Yes_________ No__________
If yes, please list below:
Dogs___________ How many?___________ Number spayed or neutered?______________
Cats___________ How many? __________ Number spayed or neutered? _______________
Are your current pets up to date on their vaccinations? _________________________________________________________________________________
What vaccinations do you give your pets? ___________________________________________________________________________________________
Number of children in the home where the pet will reside? _____________________________ Children's Ages___________________________________
Have you discussed this pet with your family? Yes______________ No____________
Name of your Veterinarian_______________________________________________________________________________________________________
(We remind you of the importance of regular vet care; keeping up with all shots, immunizations and year-round heartworm prevention is the adopters responsibility.)
Will the pet be inside? ________ outside?__________ or both?___________
If outside, please describe the type of shelter you will provide for the animal. _____________________________________________________________________________________________________________________________
(We remind you that it is very important to provide lots of attention and exercise on a daily basis for your new pet, especially if they are alone during the day. Regular exercise and attention makes for a happy dog and keeps destructive behavior to a minimum. A lonely or bored animal may begin to dig, try to run away, or become unpleasant to be around.)
Would you like NEAHS membership information on ways you can save 10% off vet visits? Yes______________ No _________________
August 2008
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Adoption Application
1 for office (attached to adoption form) 1 for adopter
I,_____________________, upon adopting a pet from the NEAHS agree to the following:
1. I will not keep my pet on a chain or tied up in any manner.
2. I will keep my dog in an enclosed fence, on a running line or on a leash when not in my home.
3. I give the NEAHS permission to inspect my pet's new home and repossess the animal if it is found to be receiving inadequate care or if I do not abide by the terms in the adoption contract in any way.
4. If you are unable to care and provide for your pet, please make every effort to find it a good home. You may bring it back to the NEAHS, but please understand, we will ask you for a surrender fee donation to cover expenses.
I have read and understood the ADOPTION policies of the NEAHS. By signing this form, I agree to abide by all the terms as stated above.
Adopter's Name (please print)______________________ Adopter's Signature, date___________________
August 2008
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Adoption Application
Animal Information
Top Area for Office Use Only; ADOPTER please read section below; SIGN AND DATE
Date Animal Adopted ___________________________ Animal Tag # __________________________ dog pup cat kitten
Age___________________ Sex _________________
Description ____________________________________ Shots/Wormed ____________________________________________________
Cage # ____________________________ Vet Name _________________________________________(see key below)
Is the animal already Spayed/Neutered? Yes________ No__________
________________________________________________________________________________________________________________
KEY: AMC Animal Medical Center CATO Cato Pet Hospital
HVC Hilltop Vet Clinic JFPC Jonesboro Family Pet
SWD Southwest Drive animal VC Vet Care
WAC Wood Springs Animal Clinic
________________________________________________________________________________________________________________
Adopter Read and Sign Below:
Upon adopting a pet from the NEAHS, I agree to the following:
1. I will not keep my pet on a chain or tied up in ANY manner.
2. I will keep my dog in an enclosed fence, on a running line, or on a leash when outside.
3. I give the NEAHS permission to inspect my pet's new home and repossess the animal if it is found
to be receiving in adequate care, or if I do not abide by the terms of this adoption contract.
4. If I am unable to care or provide for the pet, I will make every effort to find it a good home. If I cannot
find an appropriate home, I will return the animal to the NEAHS. I understand that I will be asked
for a surrender fee to cover expenses.
5. I understand that the NEAHS are unable to give the Rabies Vaccination. I also understand that I
have 30 days to get my animal a Rabies Vaccination provided that they are of age to have it. If they
are too young to receive the shot during the 30 day period, I understand that I am to get the
vaccination as soon as it is able to be administered.
6. As the Adopter, I understand that I assume full responsibility for any veterinary bills that occur after Adopting
the animal.
I have read and understand the adoption policies of NEAHS. By signing this form, I agree to abide by all
terms as stated above.
ADOPTER'S SIGNATURE________________________________________________________ DATE:________________________
PRINTED NAME _________________________________________ D.L. # _______________________________________________
August 2008
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Surrender Policy
The NEAHS shelter does not receive local, state or federal funds. Therefore, it is necessary to collect surrender fees in order to be able to care for the animals and operate the shelter. The NEAHS reserves the right to refuse to accept any animal.
It is not the policy of this shelter to accept surrendered animals for the sole purpose of euthanasia. It is YOUR responsibility to weigh the risks and benefits to your pet when surrendering it. The NEAHS makes every effort to ensure the animals we adopt are placed, not just anywhere, but with people who will provide good care for the animal for the rest of its life. Animals that cannot be offered for adoption or do not get adopted will be humanely euthanized. The NEAHS cannot notify you before your pet is euthanized or return it to you if it is not adopted.
How long are animals kept at the shelter? Once an animal has been surrendered to the NEAHS, there is no specific amount of time that it may be kept before it is adopted or humanely euthanized. Some animals may never be available for adoption. Others may remain available for adoption for longer. Factors that determine if and how long an animal will be available for adoption include: health, behavioral and training history, behavior at the shelter, age and the amount of available space at the shelter. Every surrendered animal is re-evaluated daily with respect to these factors and the most healthy, socially adjusted animals are allowed to live in the available space at the shelter.
At the NEAHS, we attempt to keep an animal for a minimum of five (5) days. However, conditions may make it necessary for an animal to be euthanized within hours of its surrender. If the animal's immediate health or behavioral conditions are questionable, the Shelter Director shall have the final decision regarding the disposition of the animal.
Before you surrender the animal, consider your options! remember, the NEAHS is your LAST option...please try to keep your pet, or find it a good home yourself.
- Visit the local vets and ask to leave a notice that you have a pet that needs a good home on their bulletin board.
- Place an ad in the newspaper for someone willing to give your pet a good home.
- Give the NEAHS and other local humane organizations your name and number so we can assist in finding your pet a good home while you continue to provide for your pet.
If you decide to surrender your animal to the NEAHS, you must pay the surrender fee (see below) to help cover the costs of caring for your animal. The surrender fee only provides for a small portion of costs associated with providing basic care.
SURRENDER FEES
Miscellaneous Surrender: Kittens $5.00 each; Cats over six months: $15.00 each; Puppies $5.00 each; Dogs over six month: $15.00 each.
Owner Surrender: Kittens $10.00 each; Cats over six months: $25.00 each; Puppies $10.00 each; Dogs over six months $25.00 each.
Emergency Surrender: Please contact the NEAHS Executive Director or Shelter Supervisor for information.
PLEASE PRINT CLEARLY
Name_____________________________Driver's License #__________State____
Address_________________________City____________State_____Zip________
Daytime work phone__________Evening home phone________________
Signature_______________________________
NEAHS Employee Name_______________________
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Refund/Exchange Policy
1 copy for office; 1 copy for adopter
Date Adopted:__________(month, day, year)
Date of Vet Appointment:____________(month, day, year)
1. If the adopted animal gets sick, or other problem is discovered within 14 days from the day after the date of vet appointment (see above), the NEAHS will offer to EXCHANGE ONLY. The exchange must be made within the 14 day period. Problems may include digging, biting, behavioral problems, destructive habits.
2. No vet costs other than spay/neuter are the responsibility of NEAHS. Adopter is responsible for all vet costs. No exceptions.
2A. PLEASE NOTE: Occasionally a condition or medical problem may exist that needs vet care, which is not obvious to the NEAHS while the animal is at the shelter. If something is discovered by the vet, and the NEAHS wasn't aware of the problem or condition while the animal was at the shelter, the NEAHS is not responsible for treatment costs.
3. If the animal is diagnosed with a fatal illness or dies within 14 days from the day after the date of the vet appointment (see above), the NEAHS will issue a REFUND OR EXCHANGE during this period only. The adopter must furnish to the NEAHS a signed statement on veterinarian letterhead from the vet stating that the animal has died or is suffering from a fatal illness and is not expected to recover.
5. If you adopt an animal that has a pre-existing condition(s) (such as heartworms, upper respiratory (cats & dogs, etc.) we are not responsible for any costs incurred for treatment of the pre-existing condition(s).
If an animal has a pre-existing condition(s) that the NEAHS is aware of at the time of adoption, the following section is to be completed by NEAHS staff member.
---------------------------------------------------------------------------------------------
Please print
This animal has the following condition(s)___________________________________
NEAHS staff member (printed name and date)_________________________
I have read and understood the REFUND/EXCHANGE POLICY of the NEAHS. By signing this form, I agree to abide by all the terms stated above.
Adopter's Name (please print)___________________________
Adopter's Signature and Date____________________________
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Heartworm Testing Information and Policy
Dogs over six (6) months of age are tested for heartworms by an occult antigen test.The antigen test detects the presence of adult heartworms. There are times when the test result will be negative (no evidence of heartworms) at the time of adoption. But, at a later date (weeks to months) when re-tested, the result will be positive (infected with heartworms).
This is due to the fact that when a mosquito injects an infective heartworm larva into a dog, it will take five to six (5-6) months for that larva to mature and become an "adult" worm living in the dog's heart.
As an example, if a dog has been exposed to mosquitoes in May, June or July and the dog is tested in August, the test result will be negative, because there are no adult worms present at the time of testing, even though the dog has developing heartworms. If this same dog is re-tested in November or December, the test result will be positive, since enough time has elapsed since exposure for the test to indicate the presence of adult heartworms.
For this reason, NEAHS can not be responsible for veterinarian costs resulting from heartworm treatment, if such treatment is required as a result of a later test indicating the presence of heartworms.
.....................................................................................................................................
Please check one
This animal has tested POSITIVE for heartworms_____
This animal has tested NEGATIVE for heartworms_____
NEAHS Employee (printed name and date) ____________________________________
I have read and understood the HEARTWORM TESTING INFORMATION/POLICY of the NEAHS. By signing this form, I agree to abide by all the terms as stated above.
Adopter's Name (please print)______________________________________________
Adopter's Signature and Date_______________________________________________
January 2002
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POLICY COVERING USE OF NEAHS TRAPS
The following policy shall govern the use of NEAHS animal traps. This policy shall be in force and shall apply to all persons desiring to "borrow" one or more traps from the Northeast Arkansas Humane Society.
By your signature on a copy of this policy you agreed to abide by this policy in regard to your use of our trap(s). If you do not wish to agree to the terms of this policy, we shall not be able to loan our traps. This policy has been put into effect to offset the cost associated with having to replace numerous traps that have never been returned, returned in a damaged condition, or in other conditions that render the trap useless to anyone.
There shall be a $25.00 deposit per animal trap. This deposit shall be returned in full when you return the trap to the NEAHS in the same condition as you received it. This includes cleaning the trap before returning to the shelter.
In order to borrow an animal trap, you must present a photo identification card.
You must provide your name, a home address, work phone number, home phone number.
You must agree to return the trap to the shelter in 5 calendar days or less. If you require additional time, you can call the Shelter Director and request to extend the return for up to 5 additional days.
If you lose the trap, it is damaged beyond use, or you simply do not return the trap, you hereby agree to replace it with a new trap, or you will pay $25.00 in addition to the $25.00 deposit.
The use of this trap does not imply that the animal caught will be accepted by the NEAHS shelter. If accepted by NEAHS, the animal(s) become the property of NEAHS, and shall be subject to NEAHS Surrender fees in effect at the time.
Trapping any animal may be hazardous. The person borrowing this trap agrees to hold the NEAHS harmless against any liability arising out of the use of this trap.
The undersigned accepts the trap, or traps, in a clean and good working condition, and agrees to return them in the same condition.
Trap to be used for (describe animal & locations):_______________________________
Name:________________________ Address: __________________ City: ___________________
Home phone: ______________ Work phone:______________ Driver's license #: _________________
Employed by: _____________________
NEAHS employee:_______________ Date Out: _________Return Due Date: __________
Policy and associated fees are subject to change without notice by action of NEAHS Board of Directors. Effective Date: 11-1-01
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