Adoption Application

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Interested in adopting from Cedar Bend Humane Society?

Cedar Bend Humane Society's adoption center welcomes visitors daily from 12:00 p.m. to 6:00 p.m. with no appointment necessary. We hope to see you soon!

VIEW ADOPTABLE PETS

Complete the form below. Once it has been reviewed, you will be contacted by a Cedar Bend Humane Society adoption counselor within 24-48 hours. Approved applications are held for 90 days.

Please complete the following information as thoroughly as possible and click the SUBMIT button to send the information to us. All questions need to be answered to be considered for adoption. Alternatively, you may download and fill out a printable version of this form and return it to us at your convenience.

To check on the status of your application after the 48 hour review period, please contact our adoption team at 319-232-6887 or adoptioncounselor@cedarbendhumane.org.

Thank you for considering rescuing a homeless pet from Cedar Bend Humane Society!

Download Printable Application »

* indicates a required field

I want to find:

What kind of animal are you looking for?

Cat

Dog

Other

List any animal(s) in our shelter you are specifically interested in here:

Contact Information:

Name: *

Address:

City:

State:

Zip:

Home Phone (##########):*

Work Phone:

Email: *

Please answer all of the following questions:

1. Will you spay or neuter your pet?

2. Age

3. How long have you lived at this address?

4. Do you own?

5. Do you rent?

6. Landlord's Name

7. Landlord's phone number

8. Number of other adults in household

9. Ages of children living in household

10. Any household resident planning to move in next 1 - 2 years?

Yes

11. Household's source of income

12. Employer

13. Does anyone in your household have allergies? To What?

14. Do you have any other pets at home now? What?

15. Who is/was your veterinarian?

16. In what city is your vet located?

17. If you have pets now, are they spayed or neutered?

Yes

18. If you have pets now, when did they last see a vet? Why?

19. Have you had any other pets? What kinds?

20. What happened to them?

21. Who will be primarily responsible for pet care (grooming,training, etc)

22. Your pet will live:

If other, please specify:

23. Your pet will sleep:

If other, please specify:

24. In your usual week, what is the longest time your pet will be alone?

25. Where will the pet be kept when it is home alone?

26. Briefly, how would you deal with the following, if they became a problem:

Housebreaking (for a dog)/ not finding a litterbox (for a cat)

Keeping the dog/cat in the yard

Too much barking (for a dog)/scratching for a cat

Play-biting

Destructiveness

Aggressiveness

27. If a vet diagnosed a condition that would cost over $150 to treat, what would you do?

28. What circumstances would cause you to give up a pet?

29. How did you hear about our shelter?

By checking the box below you are certifying to the truth of your answers. If any of your answers prove to be untrue the adoption will not proceed. If you have taken the adopted pet home, the adoption will be voided and on notice to you, the pet will be returned to the Cedar Bend Humane Society.

I certify that all my answers are true*
You must certify your answers by checking the box.

Date (MM/DD/YYYY)*:

Get in Touch

Cedar Bend Humane Society

1166 West Airline Highway
Waterloo, IA 50703-9634

Phone
319-232-6887

Fax
319-235-2597

Adoption Center Hours
Open daily: 12pm - 6pm

Intake Center Hours
Open daily: 9am - 5pm
Closed daily 12pm - 1pm for lunch

Waterloo Animal Control Hours

Open daily: 7am - 4pm

Phone
319-883-0797

Cedar Falls Animal Control Phone
319-291-2515