Cat Owner Surrender Form

Cat Owner Surrender Form
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cat's Name*
Breed*
If other, please list breed:
Sex of the cat*
Is your cat (select one):*

SpayedNeuteredUnaltered
Age of the cat*
Picture of the cat:*

Browse Files

Cancelof
Reason for surrendering*
Does your cat see a Veterinarian for annual vaccines?*
Name of Vet Clinic he/she sees.
Who's name will your cat be under at the Vets office listed above?
Does your cat have any medical concerns?*

YesNo
If Yes, please explain:
Does your cat have experience with any other animals? What kinds and how did they get along?*
Does your cat use the litter box?*
If you answered sometimes, how often does he/she make mistakes?
What type of litter does your cat use? *
What type of litter box does your cat use?*
What is your cats favorite toy? (please select all that apply)*

Stuffed MiceCatnip ToysLaser PointerFeather/String WandsAll ToysNone
How does your cat like to play? (please select all that apply)*

Plays gently, does not usually use teeth or clawsLikes to play roughLikes to chase and pounce with variety of toysLikes things that crackle, such as paper bagsLikes to play hide and seekWill fetch items like bottle caps or toysLikes to play in or around waterLikes to learn new tricks for treatsLikes to play with other catsLikes to play with dogsNot interested in playChases bugs or moths
What areas of your home did the cat have access to? (please check all that apply)*

Outdoors OnlyIndoors at nightOutdoors in warm weatherScreened in porchGarageIndoors in coldIndoors with access to outsideBarn or shed
Where did your cat spend most of its time? (please check all that apply)*

BedroomKitchenLivingroomBarn or ShedWith peopleGarageAt the windowOutdoors only
Does your cat have any of the following behavioral issues?(please check all that apply)*

Scratching FurnitureJumping on countersSprayingChewing electric cordsEscaping outsideClimbing curtainsSwatting aggressivelyChewing PlantsOther: Please answer next question.
Explain your answer of other here.
Is there anything else you would like to add?
* I understand that I must receive confirmation from Whisker Hill Animal Rescue that accommodations can be made for the described animal before ownership can be transferred.

* I understand that the applicable surrender fee must be paid in full before ownership can be transferred.

* I hereby give Whisker Hill Animal Rescue permission to request all medical history and medical records from my Veterinarian for the animal I am relinquishing.

*I acknowledge that my signature on this receipt relinquishes all claims of ownership of the animal(s) described. Neither my family, any representatives acting on my behalf, nor I may assert present and/or future claims, suites, or otherwise against Whisker Hill Animal Rescue with respect to this animal(s). I understand that Whisker Hill Animal Rescue will not return this animal to me, once left in its care, under any circumstances, unless otherwise approved by Whisker Hill Animal Rescue.
Signature*

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