Columbiana County Humane Society

Adoption Application
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. 
Are all the animals in your household spayed or neutered? *
Please select all the qualities that you are looking for in a dog *
Please select all the qualities that you are looking for in a cat *
Do you plan to crop the ears or tail or debark your new dog? *
Do you plan to declaw your cat? *
Would your new pet have any of the following visiting: *
What are some training needs that you do not wish to encounter *
There are some behaviors that require patience, formal training, or prior dog experience. If your new dog does display any of these behaviors, how will you go about teaching him/her? *
How would you describe your household? *
When you are home, where will you new dog be? *
When you are NOT home, where will your new Dog be? *
All dogs require exercise. How will your new dog get adequate exercise? *
Do you have a steady source of income? *
There are additional expenses for pets for routine care and possible unexpected medical costs. Are you prepared to be financially responsible for you new pet? *
It may take weeks for the new dog to adjust to a different environment. It may even require keeping the animals separate to introduce them properly. Are you prepared to handle this? *
In a new environment it can be hard to determine if an animal is housebroken. Will you be able to tolerate accidents and train the pet? *
Are all family members in agreement about adopting a dog/cat? *
Have you or any member of your household been subject to legal action for cruelty to, neglect of, or abandonment of any animal? *
Home checks are required prior to adoption. Will you allow us to complete a home check? *
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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