Form test Your Full Name (First and Last)* Your Email* Your Phone Number* Cell or Work Phone Number Your Address (Please include City and Zip Code)* Do you own or rent?* Number of people in your home?* Number of children in your home? (Please include ages) Do you have a fenced-in yard?* Type of fence? Height of fence? Will pet live inside, outside, or both?* Will pet need to use the stairs?* What are you looking for in a pet? Is there a specific pet that interests you?* Please list your current pets with a description and age of each.* Please list pets you have previously had, and why they are no longer with you. Name of current and previous veterinarian(s)?* Phone number of current and previous veterinarian(s)?* How do you correct unwanted behaviors in a pet? Please give an example.* I declare that the above is true to the best of my knowledge and ability. By submitting this application, I authorize the veterinarian listed to release any medical information of my current or previous pets.