Department of Public Safety - Animal Care & Control Division

Are all your pets current on rabies vaccines and County License Tags? *This question is required.

• Yes
• No

Have you or any member of your household ever been charged/convicted of Animal Cruelty in any State/County? *This question is required.

• Yes
• No

New pets require up to 3 months adjusting to a new home. Are you able to allow for this adjustment period? *This question is required.

• Yes
• No

This pet may not be housebroken, may chew, eat plants and/or scratch furniture. Are you able to provide remedial training, if needed? *This question is required.

• Yes
• No

If you are adopting or have dogs and plan to house them outdoors, are you providing the minimum required outdoor shelter? *This question is required.

• Yes
• No

Would you object to a follow-up visit or phone call to check on the progress of your new pet? *This question is required.

• Yes
• No

I wish to adopt an animal from the Palm Beach County Animal Care and Control Division and I certify that the prior information I have provided is true and accurate. I also understand and agree to the following indicated below:
 

ADOPTION AGREEMENT *This question is required.

• ALL adopted dogs and cats will be spayed/neutered by Animal Care and Control prior to being released to the adopter in accordance with FLORIDA STATE STATUTE 823.15 (REQUIRES THAT ALL DOGS/CATS ADOPTED FROM AN ANIMAL SHELTER MUST BE SPAYED OR NEUTERED.)
• The medical processing. procedure includes a general physical exam, necessary medical tests, preliminary worming, rabies and other necessary vaccines, a spay or neuter operation, permanent microchip I.D. and a Palm Beach County rabies license tag. The Animal Care and Control Division's veterinarian will make a substantial effort to see that all adopted pets are in good health, however, it is possible that an undetectable illnesses may be incubating at the time of adoption.
• Adopters who wish to adopt pets with known physical defects or ailments must make prior arrangements with their private veterinarians to initiate immediate medical follow-up for the adopted pet. New pet owners should contact and follow the advice of their private veterinarian as soon as possible.
• I will provide timely, appropriate medical and behavioral care and a humane existence in accordance with laws for any pet that I adopt from Palm Beach County Animal Care and Control.
• I understand that treatment and prognosis for my adopted pet are my financial responsibility and are dependent upon my pursuance of advanced medical behavior and therapy. I hereby release Palm Beach County Animal Care and Control from all responsibility and liability.
• Palm Beach County Animal Care and Control provides no guarantee of any pet's age, behavior, breed, or general disposition and I may be required to sign a known medical or behavior form.
• I will ensure that all pets in my household are current on rabies vaccinations and obtain county license tags for all as required by law.
• I will notify Animal Care and Control immediately upon transfer of ownership (Telephone: 561-233-1272).
• I will read all documents provided including, but not limited to, documents describing upper respiratory illnesses, parvo virus, and cat distemper.
• Failure to abide by this agreement may result in civil and/or criminal proceedings against the adopter and/or impoundment of the adopted pet. When civil action becomes necessary, I agree to be liable for attorney's fees should the County prevail. I understand that should I violate this agreement, I may not be permitted to adopt any pets from Animal Care and Control
• By acceptance of the sample bag of pet food, I authorize ACC to give my name, address, and email information to Hill's Science Diet for statistical research.

To be completed by Animal Care & Control Personnel

	Animal ID	Type			Screening			Rabies License Tag No.
		Cat	Dog	Other	Spayed	Neutered	Intact
1	Animal ID	1: Type: Cat	1: Type: Dog	1: Type: Other	1: Screening: Spayed	1: Screening: Neutered	1: Screening: Intact	Rabies License Tag No.
2	Animal ID	2: Type: Cat	2: Type: Dog	2: Type: Other	2: Screening: Spayed	2: Screening: Neutered	2: Screening: Intact	Rabies License Tag No.
3	Animal ID	3: Type: Cat	3: Type: Dog	3: Type: Other	3: Screening: Spayed	3: Screening: Neutered	3: Screening: Intact	Rabies License Tag No.