Cat Haven Owned Surrender Form

I confirm that this cat(s) is owned by me, or that I am acting under direction from the owner, and that by completing and signing this declaration, I am signing all claim of ownership to Cat Haven.

I understand that Cat Haven is now responsible for any decisions relating to the welfare of this cat, including rehoming and euthanasia. In addition, I am aware that no further discussion will be entered into and that the outcome relating to this cat will not be made available to me.

Cat Haven has a fee for this service. Additionally, a fully tax deductible donation is greatly appreciated to ensure that this service can continue.

Signature*

Please tick the appropriate box:*

Surrendered at Cat Haven with appointment - $65 per catSurrendered at Cat Haven without appointment - $130 per cat

Cat Haven requires an appointment for this service. To book an appointment, please call on 9442 3600 between 10am-4pm, or email admin@cathaven.com.au

Date of booked appointment*

Date

Your Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

SuburbPostcode

Council

Mobile*

Area CodePhone Number

Email*

example@example.com

Who is bringing in the cat/s?*

If someone else is bringing the cat in on your behalf, please complete the details below for the person bringing the cat in to Cat Haven.

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityPostcode

Council

How many cats are you surrendering?*

For more than 3 cats, please select 4+ and complete a second version of this form for the additional cats.

Details of Cat - 1*

Cat Name

Breed

DOB or Approx. AgeColour

Gender

Please tick the appropriate boxes*

If Microchipped, Microchip number*

*If known

If Vaccinated, date of last Vaccination

Date

Name of Usual Vet Clinic*

Why are you surrendering this cat?*

Eg. moving, owner unwell, behavioural problems of cat, issues with another animal, etc.

Does this cat have any behavioral problems?*

Has the 2021 temporary tenancy moratorium contributed to your decision to surrender this cat?*

YesNo

Details of Cat - 2

Cat Name

Breed

DOB or Approx. AgeColour

Gender

Please tick the appropriate boxes

If Vaccinated, date of last Vaccination

Date

Name of Usual Vet Clinic

Why are you surrendering this cat?

Eg. moving, owner unwell, behavioural problems of cat, issues with another animal, etc.

Does this cat have any behavioral problems?

Has the 2021 temporary tenancy moratorium contributed to your decision to surrender this cat?

YesNo

Details of Cat - 3

Cat Name

Breed

DOB or Approx. AgeColour

Gender

Please tick the appropriate boxes

If Vaccinated, date of last Vaccination

Date

Name of Usual Vet Clinic

Why are you surrendering this cat?

Eg. moving, owner unwell, behavioural problems of cat, issues with another animal, etc.

Does this cat have any behavioral problems?

Has the 2021 temporary tenancy moratorium contributed to your decision to surrender this cat?

YesNo

*If you are surrendering more than 3 cats, please submit this form and complete a new form for the remaining animals.

Cat Haven Owned Cat Surrender Form

Incoming Cat Profile