HART Relinquishment Request Form

Relinquishment Request Form

Please fill out as much information as possible so that we can find the best outcome for your cat, kitten, or litter.
I would like to surrender:
Number of Cats/Kittens
Cat's Name(s)?
(or type N/A or Unknown)
Approximate Age?
Gender of Cat:
Contact Info
Your Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Your town or city
Email
example@example.com
About the Cat(s)
Are you the owner?
Owner's Name (if known)
I believe the cat/kitten/litter is:
Did you adopt this cat or kitten at HART?
Where did you get the cat from?
What was the cat's name at HART?
When (month/year) did you adopt the cat from HART?
Have you relinquished a cat to HART in the past?
How long have you had your cat(s)?
Street/City where cat was found

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Living Conditions:
Cat/Kitten/Litter's temperment is:
Does the cat/kitten(s) feel comfortable around:
Food: Brands/Flavors currently eating:
Please Specify wet or dry
Litter: Brand/Type currently using:
Physical Description:
Size, Breed, Color, Length of Fur
Personality:
Likes:
Favorite toys or activities
Dislikes:
What have you done to find the owner? (check all that apply)

Other
Describe the reason you wish to relinquish this cat/kitten/litter.
Describe in detail where and how the cat/kitten/litter was found.
Describe each kitten in the litter - description, health, personality.
Describe any health or behavioral issues the cats or kittens have.
Describe each of your cats or kittens - breed and physical description, health, personality, likes/dislikes, and favorite activities.
Do you have a photo of the cat/kitten/litter?

Cancelof
About You
Today's Date

MonthDayYear
Date placement is needed by:

MonthDayYear
Date
Would you be willing to foster the cat/kitten/litter temporarily?

Other
Are you able to afford a $50 relinquishment fee?

Other
What would need to happen in order for you to keep the cat/kitten/litter?
Should be Empty:

Relinquishment Request Form

Contact Info

About the Cat(s)

About You