Cat Surrender Request Form
Once your surrender request is received, a staff member will reach out to see how and when we may be able to help you. Please note that there is a long wait list for cat surrenders. If you have multiple adult animals in the household that you need to surrender, please complete one form per animal. Only one form is needed for a litter of kittens. This surrender form is for PICKAWAY COUNTY RESIDENTS ONLY.
Are you willing to pay $30 (per adult cat) or $15 (per kitten, $80 cap) surrender fee?
*
Yes
No
I am unable to pay a surrender fee
Date
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email (primary way we will contact you)
*
example@example.com
I NEED TO SURRENDER
(Enter #)
*
CAT(s).
Reason For Surrender:
*
If this is a litter of kittens, do you want to surrender their Mom?
Yes
No
Name of Cat:
*
How long have you owned the cat?
*
This Cat is:
*
Male
Female
Unknown
Litter of Kittens
Where Did you get the cat?
*
Shelter/Rescue
Found Stray
Pet Store/Breeder
Giveaway
Other
If from another shelter or rescue, which shelter/rescue?
Has this cat been seen by a Veterinarian?
*
Yes
No
If yes, What vet do you use for the cat?
Does the animal have any past or current medical concerns or conditions?
*
Yes
No
If YES, please describe the animal's medical concerns and/or conditions:
Is this cat spayed/neutered?
*
Yes
No
Unknown
Is this cat current on vaccines? (if yes, you will need to present paperwork on the day of surrender)
*
Yes
No
Unknown
Is the cat good with (select all that apply):
*
Men
Women
Children
Other Cats
Dogs
Unknown
Is this cat NOT good with (select all that apply):
*
Men
Women
Children
Other Cats
Dogs
Unknown
Cat is good with all of the above
Breed/Description:
Can the cat easily be caught, picked up, and carried?
*
Yes
No
Attach a photo of the cat that you would like to surrender:
*
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Please provide any additional information about the cat below.
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