Country Hill Animal Shelter - Pre Home Check Form
Please fill out this form and one of our team will be in touch
Date
-
Day
-
Month
Year
Date
Title
Please Select
Mr
Mrs
Miss
Ms
Prefer not to say
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City/Town
County
Postal Code
Telephone Number
Email
example@example.com
Describe your Home
Please Select
House
Bungalow
Flat
Ground Floor Flat
Other
Do you own or rent?
Please Select
Own
Rent
If you are renting, does your Landlord permit you to have pets?
Please Select
Yes, I have Landlord consent
No, I do not have Landlord consent
I am in the process of getting Landlord consent
Do you live near a busy road?
Please Select
I live in a very rural area
I live by small country lanes
I live in a cul de sac near larger roads
I live by a main road
I live near lots of traffic and would need an indoor only cat
How long have you lived at this address?
e.g., 2 years and 5 months
Do you plan to move within the next year?
Yes
No
Do you have a garden?
Please Select
Yes - a small garden
Yes - a medium garden
Yes - a large garden
No - I do not have a garden
Do you have a cat flap?
Please Select
Yes
No, I am prepared to fit one
No, I won't be able to fit one
How many adults in your household?
Please Select
1
2
3
4
5
6
7
8
9+
How many children in your household?
Please Select
0
1
2
3
4
5
6
7
8
9+
Ages?
Do you work?
Please Select
Yes - Full time
Yes - Part time
No
At most, how many hours will the cat/s be left during the day?
Pets currently owned, Species & how many?
Have you owned a cat before?
Yes
No
Where will the cat/s sleep at night?
Do you have plans to go on holiday in the next 8 weeks?
Please Select
Yes
No
When you go on holiday, who will look after the cat/s?
Notes
We are BY APPOINTMENT ONLY to ensure that every customer and cat receives the best possible service and attention. We kindly ask all visits to our premises be pre-arranged and confirmed over the phone by a member of our team. If you arrive without a confirmed appointment, we may not be able to accommodate you at that time and will likely need to reschedule your visit. Thank you for your understanding.
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