Columbiana County Humane Society

Adoption Questionnaire
Columbiana County Humane Society takes in abused, neglected, and abandoned animals,
as well as those that are sometimes ordered removed by the courts.
We make every attempt to screen our animals for health, behavior and temperament issues.
Certain types of problems may not demonstrate themselves until the animal is in a home environment. 
For these reasons we cannot guarantee the behavior, health or temperament of any animal. 
There are additional expenses for pets for routine care and possible unexpected medical costs. Are you prepared to be financially responsible for your new pet? *
In a new environment, it can be hard to determine if an animal is housebroken. Will you be able to tolerate accidents and train your new pet? *
Are all family members in agreement about adopting a new pet? *
Have you or any member of your household been subject to legal action for cruelty to, neglect of, or abandonment of any animal? *
Will you allow us to complete a home check prior to adoption? *
I understand that purposeful falsification of the information contained in this form will result in automatic denial of an adoption, or subsequent confiscation of already adopted pet (s). I certify that the information I have provided herein is accurate and I authorize Columbiana County Humane Society (CCHS) to investigate all statements made on this questionnaire. I understand that Columbiana County Humane Society makes no representation or guarantee about any animal's temperament, behavior, health or any combination thereof. CCHS is not held liable for any future injury or damage, which may be caused by any adopted animal, nor is CCHS responsible for any illness or medical malady, which may befall the animal subsequent to adoption. CCHS reserves the right, at our sole discretion, to refuse any applicant for any reason. *
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