Rescue & Hospice

Accuracy: meters
Thank you for allowing us to provide your care at home! By signing this document, you are agreeing that the clinician was present at the date and time stated and performed skilled treatment. Your signature will be used to verify the visit as well as the location of service. If there are any discrepancies, please notify our office!

When you are ready to sign, please tap the "Capture Signature" button below.

Adoption Application
Applicant Information
October 2, 2023
Phone Number:
Date of Birth:
Driver's License Number:
State Issued:
Property Type:

E-mail Address:
Landlord Name:
Landlord Telephone:
Clinic Name:
Phone Number:
Previous/Current Pets
Type Breed Age Sex Altered How Long? Still Present
If any pets are no longer present, please explain:
Household Information
Name Age Relationship to Applicant Gender

When Not Home:
House Training:

Name Relationship Phone Number
If you have any additional comments regarding your application, or are interested in any specific beagles, please indicate below:
Please read and sign: There are many factors that go into the pet adoption process. I understand that each beagle has individual needs and will go to the home that is best fit for them. I understand that the approval for adoption is contingent upon the best interest of each beagle as an individual and that I have the right for clarification if my application is rejected. I agree that if adopted, and there are any problems, the beagle will be returned to the rescue at any time and that I will be asked for the reasons that the beagle was not a good fit so as to facilitate appropriate future adoption.
By signing below, I indicate that I have read the agreement and information provided and certify that all statements made by me in this adoption application are true.

**If completing this form on a touch screen device, you can sign on the line below. Alternatively, you can choose "Create Link" and then sign on a touch screen device.
 Applicant's Printed Name

 Applicant's Signature
 Witness's Printed Name

 Witness's Signature