TE_N__Stray_Animal_Adoption_Contract.doc

FORT HOOD STRAY FACILITY

80TH & Engineer Dr. Bldg. 4902

Fort Hood, Texas 76544

Phone: 254-287-4675

Fax: 254 288-0440

Conditional Agreement for Adoption & Sterilization

FH SAF Staff Signature:

FORT HOOD STRAY ANIMAL FACILITY

Stray Animal Adoption and Sterilization Form

LOG #

Date:

Persons eligible to adopt stray animals from the Fort Hood Stray Animal Facility are all military beneficiaries and civilians. Non-Military ID card holders who adopt animals are not eligible for services at the Fort Hood Veterinary Treatment Facility after adoption.

Services Rendered Prior to Adoption:

· All necessary vaccinations

· Heartworm testing for Dogs over 6 months of age

· Feline Leukemia testing for all Cats

· De-worming for intestinal parasites

· Microchip for identification of animal

Adoption Release:

I understand that the animal(s) I have adopted may have been exposed to disease either before or during the impoundment period. I understand the vaccinations given at the time of adoption will offer little or no protection for animals already exposed. Conditions that develop after adoption will be my responsibility and treated at my expense.

(initial) The staff of the Fort Hood Stray Animal Facility has advised me that there is no guarantee as to the temperament of the animals. The Staff has made every effort to screen aggressive/unsuitable pets but will not be held responsible for the future behavior of any animal.

(initial) I am adopting this animal to become a pet for my family and myself. I have given my true identity and my true address. I will be held liable for failure to comply with the provisions listed on the form, as I am the animal’s legal owner. I am aware of the 7 day return policy._____(initial) I have read and understand all of the above paragraphs regarding the adoption proceedings.

(initial)

Sterilization Agreement:

In accordance with Texas State Law Health and Safety Code, all animals adopted from the Fort Hood Stray Animal facility are required to be surgically sterilized (spayed or neutered). This must be done within 30 days after adoption or 30 days after the adopted animal becomes 6 months old. Unless a medical condition exists that precludes surgery. It is the responsibility of the new owner to arrange for an off post Veterinary Clinic to provide surgical sterilization services.

If sterilization is not completed, you as the new owner will be issued a mandatory court appearance for non-compliance. Failure to comply with the instructions on a citation will cause a warrant for arrest to be issued and the animal will be reclaimed.

I have read the following sterilization agreement and understand the terms stated above. I agree to ALL conditions as set forth.

FALSIFICATION OF ANY INFORMATION ON THIS DOCUMENT WILL RESULT IN THE REVOKING OF PRIVILEGES FROM FORT HOOD VETERINARY SERVICES.

CHAPTER 828, OF TEXAS HEALTH AND SAFETY CODE, REQUIRES STERILIZATION OF THE ADOPTED ANIMAL. A VIOLATION OF THIS CHAPTER IS A CRIMINAL OFFENSE AND IS PUNISHABLE AS A CLASS C MISDEMEANOR.

(initial)

STERILIZATION OF YOUR ANIMAL IS REQUIRED ON OR BEFORE:

Legal Owner Signature:

FH SAF Staff Signature:

OFFICE USE ONLY

Date of Adoption:

Log #

Species: Breed:

Color: Gender: Age:

Microchip #: Rabies Tag #: Exp:

Sterilization Due Date:

NEW OWNER PLEASE PRINT

Adopter Name______________________________

Sponsor Name: Rank: Spouse:

Sponsor SSN: Or DL # & State: ������____________

Address: _________________City______________State_____________Zip______

Home Phone: Cell Phone:

E-mail: _____________________________________________*optional for reminders/newsletters

Unit: Unit Phone:

**Adopter MUST provide DL # & state**