Pets

Please complete the form below for each pet you wish to keep at the property.

Alternatively you can download, print and complete a PDF version of this form and post it back into us. Download Form.
Your details
Your name:*
First Last
Your Occupancy ID:*
Your telephone number:*
Your email address:*
Have you or any member of your household ever been denied permission to keep a pet in the past?*
- Yes
- No
Have you or any member of your household ever been prosecuted for any offence against an animal?*
- Yes
- No
Please provide further details:*
Property details
Your address*
Street Address Address Line 2 City County / State / Region Eircode
Type of accommodation:*
Where the pet will be kept e.g. house, apartment – ground floor.
Does the property have direct access to its own garden?*
- Yes
- No
Does the property have direct access to a shared garden or open space?*
- Yes
- No
Please tell us a little more about the outdoor access:*

Details of the Pet you wish to keep
Type of pet you wish to keep:
- Dog
- Cat
- Other
Please state the breed and type of dog you wish to keep:*
For female dogs or cats, please state if you have arranged for anything to be done to prevent breeding:*
Please state type of other pet or pets you wish to keep:*
Can you meet the welfare needs of the pet by providing accommodation and any specialist equipment they may need?*
Please provide details:
Any other comments you wish to make?:

Declaration
Circle VHA will use the information you provide on this form for the purpose of considering your request for permission for a pet and to update you contact details if necessary.
I am applying to Circle VHA to keep the above pet(s) and by consenting to this form I am agreeing to the following:

I undertake to:
- comply with all rules relating to pets and will ensure that all persons living with me and any visitors to my home also do so
- be responsible for and supervise the pet(s)
- care for the pet(s) and its/their health and safety and overall welfare
- ensure the pet(s) does/do not cause a nuisance to neighbours or the general public
- ensure that any fouling/mess on communal areas/public paths is cleared up immediately
- ensure that the pet(s) does/do not cause any damage in the property or communal area
I understand that if I infringe the rules it may affect my tenancy.

I am aware that Circle VHA may take action against me if my pet(s) cause a nuisance which could include withdrawing permission for the pet(s) or the ending of my tenancy. If I vacate the property, I understand I must take my pet(s) with me and ensure that all items relating to the pet(s) are removed and the property is thoroughly cleaned to a standard agreed with Circle VHA. If I do leave my pet(s) in the property I give permission for Circle VHA to arrange their removal. I agree to make good any damage my pet(s) has/have caused.
Consent*
I have read Circle VHA’s Pet Policy and Procedure and agree to comply with them.
Please now click on the 'Submit' button below to send in your application. Or click on the 'Previous' button to amend your application.
Date of submission:
Date Format: MM slash DD slash YYYY
Date Assessment Completed:
Assessment completed by:
Has specialist advice or further information been requested? Please include detail:
-
Has permission been granted?
- Yes
- No
Date permission granted:
Age and photo of pet added to file:
- Yes
- No
Detail microchipping information:
Privacy*
- By using this form you agree with the storage and handling of your data by this website. *

Tenant Assistance

Pet Application Form

Step 1 of 3

Your details

Property details

Details of the Pet you wish to keep

Declaration

Need help or have questions about completing this form? Click here to contact us.

Tenant Assistance