Reptile Application

Are you financially prepared to handle a medical emergency if necessary? *

Yes

No

What is the name of the reptile you are interested in? *

Do you rent or own? *

Rent

Own

Are you committed to taking full responsibility of your pets health? Including finding an exotic vet if necessary? *

Yes

No

If you rent, what is the property owners name and phone number? *

Are you currently employed? If not, what is your source of income? *

Give two personal references. If no vet reference, add a Third Personal reference. *

List all veterinarians you have used and their contact information. *

Email *

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Name and Address *

I understand that once the adoption paperwork is complete that I am fully responsible for the health and welfare of the animal *

Yes

No

Are you aware of what this reptile needs to be properly taken care of? Please explain. *

Phone *

Are you willing to commit to an animal that could live 10 or more years? *

Yes

No

Have you ever adopted from another rescue? If so, please provide rescue(s) name and phone numbers. *

I understand the adoption fee is non-refundable *

Yes

No