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My Critter's Squeak
This Information is essential in finding a new home for your critter. We will share this form with potential new adopters.
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1
Your name
*
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This information will not be made public
First Name
Last Name
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2
Your email
*
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This information will not be made public
example@example.com
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3
Pet's Name
*
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4
DOB/Age:
*
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Approximate is okay
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5
Sex
*
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Female
Male
Unknown
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6
Is this pet spayed/neutered?
*
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Yes
No
Unknown
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7
Breed(s) (or best guess) / Color
*
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8
Reason for Surrender
*
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Please be as specific as possible
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9
Where does this pet spend their time?
*
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Inside only
Outside only
Inside and outside
Outbuilding (garage, barn, etc)
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10
How was this pet confined?
*
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Wire bottom cage
Flat/plastic bottom cage
Wire cage
Plastic cage
X-Pen
Multi-level cage
Aquarium
Outdoor hutch
Free roaming in home
Other
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11
You selected 'other'
*
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How else is this pet confined?
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12
How does your pet react when their cage is being cleaned?
*
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Allows without issues
Grunts, thumps/lunges/nips
Seems annoyed and rearranges stuff
Seems scared and runs away
Pet is removed for cleaning
Don't regularly clean cage/hutch
Other
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13
You selected 'other'
*
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How does your pet react when their cage is being cleaned?
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14
Is this pet litter box trained?
*
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Never tried
No
Yes
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15
You selected 'yes'
*
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What type of litter?
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16
How often was this pet out of cage?
*
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Daily
Weekly
Once in a while
Never
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17
When out of cage, is this pet:
*
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In a ball
Loose, whole house
Loose, specific rooms
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18
When is the pet most active?
*
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Daytime
Nighttime
Both
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19
What are your pet's favorite toys?
*
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Hanging toys
Balls
Wood and/or willow chews
Newspaper and/or towels for digging
Hard plastic toys (ex. baby keys)
Cardboard items and/or paper
Doesn't play with toys
Never given toys
Other
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20
You selected 'other'
*
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What are your pet's other favorite toys?
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21
What type of food does this pet eat?
Pellets with seed mixed in
Alfalfa based pellets
Timothy based pellets
Grass hay (ex. timothy or oat)
Alfalfa hay
Whatever is at the store
Fruits/veggies
Other
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22
You selected 'other'
*
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What other type of food does this pet eat?
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23
How does your pet drink water?
*
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Water bottle
Water bowl
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24
Does your pet enjoy being pet?
*
This field is required.
Yes, will nudge for more
Yes
No
No, runs away
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25
Does this pet like to be:
*
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Picked up - they initiate
Picked up - people initiate
Held - they initiate
Held - people initiate
Does not like to be held or picked up
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26
Where does this pet NOT like to be touched?
*
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27
Are you able to clip the nails?
*
This field is required.
Never tried
No
Yes- by myself
Yes- with a helper
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28
Has this pet spent time around cats?
*
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YES
NO
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29
What was your pet's reaction?
*
This field is required.
Friendly
Playful
Tolerant
Afraid
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30
Has this pet spent time around dogs?
*
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YES
NO
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31
What was your pet's reaction?
*
This field is required.
Friendly
Playful
Tolerant
Afraid
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32
Has this pet spent time around the same species?
*
This field is required.
YES
NO
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33
What was your pet's reaction?
*
This field is required.
Friendly
Playful
Tolerant
Afraid
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34
Has this pet spent time around other animals?
*
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YES
NO
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35
What other animals has this pet spent time around?
*
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36
What was your pet's reaction?
*
This field is required.
Friendly
Playful
Tolerant
Afraid
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37
How does this pet behave with adult family?
*
This field is required.
No adult family
Friendly
Playful
Plays gently
Plays rough
Cuddly
Reserved
Shy
Fearful
Aggressive
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38
You selected 'fearful' and/or 'aggressive'
*
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Please explain this pet's behavior with adult family
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39
How does this pet behave with family aged 9-17 years?
*
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No family aged 9-17
Friendly
Playful
Plays gently
Plays rough
Cuddly
Reserved
Shy
Fearful
Aggressive
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40
You selected 'fearful' and/or 'aggressive'
*
This field is required.
Please explain this pet's behavior with family aged 9-17 years
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41
How does this pet behave with family aged 0-8 years?
*
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No family aged 0-8
Friendly
Playful
Plays gently
Plays rough
Cuddly
Reserved
Shy
Fearful
Aggressive
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42
You selected 'fearful' and/or 'aggressive'
*
This field is required.
Please explain this pet's behavior with family aged 0-8 years
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43
How does this pet behave with adult
visitors to the home?
*
This field is required.
No adult visitors
Friendly
Playful
Plays gently
Plays rough
Cuddly
Reserved
Shy
Fearful
Aggressive
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44
You selected 'fearful' and/or 'aggressive'
*
This field is required.
Please explain this pet's behavior with adult visitors to the home
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Ok
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Ok
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45
How does this pet behave with
visitors to the home aged 9-17?
*
This field is required.
No visitors aged 9-17
Friendly
Playful
Plays gently
Plays rough
Cuddly
Reserved
Shy
Fearful
Aggressive
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46
You selected 'fearful' and/or 'aggressive'
*
This field is required.
Please explain this pet's behavior with visitors to the home aged 9-17?
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Ok
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Ok
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47
How does this pet behave with
visitors to the home aged 0-8?
*
This field is required.
No visitors aged 0-8
Friendly
Playful
Plays gently
Plays rough
Cuddly
Reserved
Shy
Fearful
Aggressive
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48
You selected 'fearful' and/or 'aggressive'
*
This field is required.
Please explain this pet's behavior with visitors to the home aged 0-8?
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Ok
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Ok
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49
What is your pet afraid of?'
*
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50
How does this pet react when afraid?
*
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(hides/kicks/etc.)
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51
What is this pet's medical history?
*
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52
Who was this pet's veterinarian?
Veterinarian name and/or clinic
Veterinarian/clinic's phone number
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53
Please sign here so we can access this pet's vet records
Clear
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54
Please add any additional information that you feel would be helpful for us or a new owner to know about this pet.
*
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55
May the new owner contact you for further information?
*
This field is required.
YES
NO
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56
Please leave your name and phone number for the new owner to contact you for further information:
*
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First name
Phone number
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