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2. Ready to Adopt? Start Here!
   City of Wichita Falls Animal Services Center
   1207 Hatton Rd Wichita Falls, TX 76302
   940-761-8894
4. Must be 18 or over to adopt an animal.
6. 
   
8. Date:*
10. Name:*
12. Street Address:*
14. City:*
16. State:*
18. Zip Code:*
20. 
    
22. Phone Number:*
24. Phone Type:

    1. Cell
    2. Work
    3. Home
26. Phone (Secondary):
28. Phone Type:

    1. Cell
    2. Work
    3. Home
30. Email Address:
32. Driver's License Number:*
34. 
    
36. Name of specific animal or cage number:
38. Name of veterinarian:
40. What type and how many pets are currently living in your home?
42. Dogs
44. Cats
46. Other animals (Please specify)
48. 
    
50. Name, Breed, Age
52. Spayed/Neutered

    1. Yes
    2. No
54. Name, Breed, Age
56. Spayed/Neutered

    1. Yes
    2. No
58. Name, Breed, Age
60. Spayed/Neutered

    1. Yes
    2. No
62. Name, Breed, Age
64. Spayed/Neutered

    1. Yes
    2. No
66. 
    
68. Are you aware of any restricitions (rules from your landlord, apartment lease) that would prevent you from adopting a pet?
70. Please check

    1. I am not allowed dogs
    2. I am not allowed cats
    3. There are size restrictions
    4. There are breed restrictions
    5. I can have any pet
    6. I have a pet deposit
    7. I own my home
72. 
    
74. For DOG ADOPTERS
76. What type of fence do you have?

    1. Chain Link
    2. Wooden
    3. Metal
    4. Other
78. How tall is your fence?

    1. 4ft
    2. 6ft
    3. 8ft
    4. Other
80. Are there any holes, gaps or broken gates around your fence where a dog can get out?

    1. Yes
    2. No
82. Although a fenced yard is not required to adopt, being a responsible pet owner is. Remember to keep your pet on a leash when not in a fenced area.
84. 
    
86. For CAT ADOPTERS
88. Do you have a quiet area in your home for your new cat to hang out for a couple of days? If not, how are you going to help your new cat adjust to your home?
90. 
    
92. Thank you for choosing City of Wichita Falls Animal Services for you new pet!
94. 
    
96. Please read and acknowledge the following:
98. The Veterinarian I will pre-pay for spay/neuter is:
100. I understand that I must turn in proof of spay/neuter and rabies to the city of Wichita Falls Animal Services within 10 days of having the procedure done.

     1. Yes
     2. No
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101. Submit

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