785-823-2217
Home
Make Appointment
Home
About Us
Location & Hours
Our Veterinarians
Our Care Team
Office tour
Contact
Services
Preventative Health Care
Diagnostic/Laboratory
Dental Services
Surgical Services
Exotic Health Care
Additional Services
Medical Services
Pet Care
Patients
Forms
Payment Options
Pet Health
Pet Health Library
Pet Health Checker
Pet Insurance Info
News
New Clinic Updates
Fear Free
Pharmacy
Press enter to begin your search
Applicants Name
*
First
Last
Applicants Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone
*
Email
Date of Birth
*
Date Format: MM slash DD slash YYYY
How many humans live in your home?
*
How many children live in your home?
*
What are the ages of your children?
*
How many animals live in your home? What kind?
*
Does everyone in your household agree with this adoption?
*
Yes
No
Does anyone in your family have pet allergies?
*
Yes
No
Type of dwelling?
*
House/Condo
Appartment
Do you ___?
*
Rent
Own
If renting, are pets allowed?
*
Yes
No
Landlords Name
Landlords Number
Do you have previous experience owning a special needs pet?
*
Yes
No
If answered yes, please provide details:
Please provide your current veterinarians name and phone number for a vet reference:
*
Are you financially ready to take care of the pet's routine/annual veterinary visits, medical treatment and emergency care if needed?
*
Yes
No
You understand that due to Forrest's circumstances, he may not be declawed or ever become an outdoor cat
*
Yes
No
Cats are very clean animals and require a clean litter box daily. This is key to preventing bad behaviors such as eliminating elsewhere in the home. Are you prepared to clean your cats littler box daily?
*
Yes
No
Forrest is very playful, this is how he gets his exercise. To prevent him from clawing your curtains or other things he must have his own toys ( such as scratching posts, bed, balls, catnip). Are you willing to supply these items for your kitty?
*
Yes
No
Are you ready to make a longterm commitment to this pet, knowing that a cat can live up to 20 years?
*
Yes
No
Should circumstances ever force you to re-home Forrest, you promise to return him to Town and Country Animal Hospital?
*
Yes
No
Electronic Signature
*
Today's Date
*
Date Format: MM slash DD slash YYYY
Home
About Us
Location & Hours
Our Veterinarians
Our Care Team
Office tour
Contact
Services
Preventative Health Care
Diagnostic/Laboratory
Dental Services
Surgical Services
Exotic Health Care
Additional Services
Medical Services
Pet Care
Patients
Forms
Payment Options
Pet Health
Pet Health Library
Pet Health Checker
Pet Insurance Info
News
New Clinic Updates
Fear Free
Pharmacy