#1

Full legal name*

#2

Date of birth

#3

Phone number

#4

Email address*

#5

Street address*

#6

City

#7

State

#8

ZIP code

#9

Occupation

#10

Housing status

#11

If renting or living with family, provide landlord/property owner name and contact information

#12

Number of adults

#13

Number of children

#14

Ages of children, if applicable

#15

Does everyone in the household support this adoption?

#16

Does anyone in the home have animal allergies?

#17

Describe any allergies or household concerns

#18

Is smoking or vaping permitted inside the home?

#19

Describe the home environment and where the animal will be housed

#20

Species interested in adopting*

#21

Specific animal, if known

#22

Why are you interested in this species or animal?*

#23

Have you owned this species before?

#24

Describe your experience with this species and other exotic animals*

#25

How long have you researched this species?

#26

What challenges do you expect with this species?

#27

Do you currently own other animals?

#28

List current animals, including species, age, sex, health status, and whether altered

#29

Have you ever surrendered, rehomed, returned, or transferred an animal?

#30

If yes, explain the circumstances

#31

Describe the diet you plan to provide*

#32

Describe the enclosure, including dimensions, materials, security, and location*

#33

Describe temperature, humidity, lighting, and environmental controls

#34

Describe enrichment, exercise, handling, and daily interaction

#35

How many hours per day will the animal typically be alone?

#36

Veterinarian name

#37

Clinic name

#38

Clinic phone

#39

How long have you been a client?

#40

May SMERR contact this veterinarian?

#41

Emergency veterinarian or after-hours care plan

#42

Describe your financial plan for routine and emergency veterinary care

#43

Do you have an evacuation or natural-disaster plan?

#44

Describe the emergency plan and transport equipment

#45

Who will care for the animal if you are unable to?

#46

Describe your vacation or extended-absence care plan

#47

Reference 1 - name, relationship, phone, and email

#48

Reference 2 - name, relationship, phone, and email

#49

I am willing to provide clear enclosure photographs or video before placement.

#50

I am willing to complete a virtual home inspection if requested.

#51

I am willing to permit a scheduled in-person home inspection if reasonably necessary.

#52

I authorize SMERR to contact the references and veterinarian listed in this application.

#53

Links or notes regarding enclosure photos, videos, or supporting documents

#54

How did you hear about SMERR?

#55

Anything else you would like us to know?

#56

I will provide appropriate species-specific housing, nutrition, clean water, sanitation, enrichment, social needs, environmental controls, and veterinary care for the animal throughout its life.

#57

I will seek prompt care from a qualified veterinarian when illness, injury, pain, or other medical concerns arise.

#58

I will not intentionally breed the adopted animal without prior written authorization from SMERR.

#59

I will comply with applicable local, state, and federal laws and maintain any permits required for the animal.

#60

I will not use the animal for fighting, illegal activity, harmful experimentation, food production, or any activity that compromises its welfare.

#61

I will not remove or alter a permanent identification device unless medically necessary and performed or directed by a licensed veterinarian.

#62

I will notify SMERR promptly if the animal is lost, stolen, seriously injured, or dies.

#63

Euthanasia will occur only upon veterinary recommendation or when necessary to prevent unnecessary suffering. When reasonably possible, I will notify SMERR beforehand.

#64

I must notify SMERR before the animal is transferred, surrendered, sold, traded, gifted, leased, rehomed, or given to any person, rescue, shelter, breeder, business, or facility.

#65

I may not independently transfer ownership or possession of the animal without first contacting SMERR.

#66

SMERR has the first right of refusal to accept the animal back as a donation before any other transfer, surrender, placement, or sale is considered.

#67

If I can no longer properly care for or keep the animal, I will contact SMERR immediately and provide reasonable information about the animal's condition, records, and current care.

#68

If SMERR is unable or declines to accept the animal, I will obtain written authorization before making an alternative placement.

#69

I understand that returning the animal does not create a right to reimbursement, refund, or repayment of expenses unless SMERR agrees otherwise in writing.

#70

I agree to reasonable follow-up communication and will provide updates, photographs, husbandry information, and veterinary documentation when requested for a legitimate welfare purpose.

#71

I will keep my contact information reasonably current with SMERR.

#72

I agree to cooperate with a reasonable welfare review when credible concerns arise.

#73

If deficiencies are identified and the animal is not in immediate danger, I agree to correct them within a reasonable timeframe communicated by SMERR.

#74

If care or placement is determined to be unsafe, unsuitable, neglectful, abusive, or materially inconsistent with this agreement, I agree to return the animal to SMERR upon request, subject to applicable law.

#75

If the animal faces immediate danger, I agree to peacefully surrender the animal upon request, and I understand SMERR may pursue lawful remedies to protect or recover the animal.

#76

I understand that violation of this agreement may result in revocation of the adoption and pursuit of remedies available under applicable law.

#77

After placement, I accept responsibility for the animal's care, conduct, and lawful possession and release SMERR and its representatives from claims arising after adoption, except where prohibited by law.

#78

This agreement is governed by Tennessee law. If any provision is held invalid or unenforceable, the remaining provisions will remain in effect.

#79

This packet and any signed species-specific addendum constitute the entire adoption agreement unless amended in writing by both parties.

#80

Electronic signatures and electronically checked acknowledgments are intended to have the same effect as handwritten signatures to the fullest extent permitted by law.

#81

Donation amount, if applicable

#82

I certify that I have read and agree to all terms in this packet.

#83

Applicant printed legal name*

#84

Applicant electronic signature (type full legal name)*

#85

Date signed

#86

Adopted animal / intake ID (rescue use)

#87

SMERR representative name

#88

SMERR representative electronic signature

#89

Representative date

#90

Placement date

#91

Rescue notes

#92

Animal category