workflow ID
Case Type
Case Status
Cat Support Services Inquiry
This form is to be completed by the owner or rescuer of the cat, the person who has the legal authority to relinquish it to Feline Rescue. Please note if the owner is recently deceased or hospitalized and you are acting on their behalf.
Tell Us About Yourself
Name
*
First Name
Last Name
Partner/Spouse/Roommate Name
First Name
Last Name
Primary Email
*
example@example.com
Secondary Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Zip Code
*
Primary Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Age
Please Select
Under 18
18-64
65 or older
Gender
Please Select
Male
Female
Other Gender
Race
Please Select
White/Caucasian
African American/Black
Native American/Alaska Native
Asian
Native Hawaiian/Pacific Islander
Other
Hispanic/Latino?
Please Select
Hispanic or Latino
Neither Hispanic nor Latino
Are you contacting us about:
*
A cat you own
A cat you found outdoors
A cat belonging to a friend/family member
A community/outdoor cat that you are concerned about
Advice/support for keeping a cat
Rehoming help
Behavior help
Veterinary/medical assistance
Something else
Please tell us specifically what you are contacting us about.
*
Emergency Safety Screening
Is this situation urgent or unsafe? (Check all that apply)
*
The cat is sick or injured right now
I cannot safely keep the cat for the next 24 hours
There is domestic violence in the home
I am unhoused and cannot shelter the cat
I plan to abandon the cat outdoors or in another location
The cat is a safety concern towards humans or other animals (biting, attacking,
aggressive)
None of the above
Case Tag
Cat Type Identification
How did this cat come into your care?
*
I adopted/own this cat
I am the owner’s next of kin
The cat showed up at my home
I found the cat somewhere else
I trapped the cat
I found kittens
Other
How many cats are you relinquishing?
*
Please Select
1
2
3
4
5
Select “1” for a litter of kittens.
Immediate Solutions
We have a few questions about support for your unique situation. The information you provide with the next few questions will help us get a better understanding of the needs in our community and how we can better support people and their cats in the future. A shelter representative will contact you regarding current service availability, as they may be limited or unavailable at this time.
Can you keep the cat temporarily?
*
Yes, for weeks
Yes, for months
No
I’m not sure/depends on support available
What, if any, resources did you utilize on your own before deciding to surrender this cat?
*
If available, would any of these resources assist you in keeping your cat?(Check all that apply)
*
Cat food and/or supplies
Low-cost or free veterinary care
Low-cost or free behavior support/pet training
Low-cost or free temporary boarding
Financial assistance for pet deposits
Information on how to find housing that accepts your pet(s)
Information on cat care support (cat sitting or daycare or pet-friendly transportation or etc)
Referral to self-rehoming platforms
Owned Cat/s
Why are you considering surrendering your cat? (Check all that apply)
*
Permanent/long-term life change:
New baby, Relationship end, Military relocation, Owner incarcerated, Owner health, Owner death & next of kin cannot keep, Other family or life change
Short-term life change:
Military relocation, Owner incarcerated, Owner health (i.e. temporarily hospitalized), Owner entering substance use treatment, Domestic abuse in the home, Other short-term change
Housing issues:
Temporary loss of home, Eviction, Restriction on number of pets, Can’t find housing that allows pets, Can’t afford pet fees, pet rent, or ongoing fees, Moving and cannot take with
Financial issues/cannot afford:
Routine wellness, Supplies (i.e. food, litter, etc.), Licensing fees, Treatment for illness/injury (non-emergency), Treatment for illness/injury (emergency), Behavior support
Behavior concerns:
Litter box issues, Nuisance behavior (i.e. escaping, scratching furniture, destructive behavior, food stealing), Pet to pet conflict, Cat to people behavior concerns, Other behavior concerns
Owner/household factors:
Allergies, Not enough time/overwhelmed, Unable to fulfill cat’s emotional or medical needs (unrelated to finances), Appearance, size, or breed type preferences, No other definitive reason for relinquishment
Other reasons
Would you be interested in any of the following as an option that doesn’t involve relinquishing your cat(s):
*
Temporary fostering
Rehoming the cat yourself with our support
Resources to help keep your cat
Low-cost veterinary resources
Behavior support
I want to surrender only, no other options
Found Cat/s
Where was the cat found?
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Has the cat been in the area for more than 24 hours?
*
Yes
No
Unsure
Does the cat appear social with people?
*
Very friendly
Tolerant but unsure
Fearful
Cannot touch the cat
I don’t know
Do you believe the cat is injured, sick, or in danger?
*
Yes
No
Please tell us more about the cat's injuries, sickness or dangerous situation.
*
Kittens
Where were the kittens found?
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Are the kittens with their mother?
*
Yes
No
Unsure
What is the estimated age of the kittens?
*
Under 4 weeks
4-8 weeks
Over 8 weeks
Cat/s Information
Animal Type
*
Please upload a photo of the cat.
*
Browse Files
Drag and drop files here
Choose a file
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of
Cat's Name
*
Cat's Gender
*
Male
Female
Unknown
Cat's Age
*
Kitten (0-4 weeks)
Kitten (5-16 weeks)
Adolescent (between 4 months and 1 year)
Adult (1-5 years)
Adult (6-9 years)
Senior (10-13 years)
Senior (14+ years)
Spayed or Neutered?
*
Yes
No
Unknown
Cat Origin:
*
I am returning a cat that was adopted from Feline Rescue
I am relinquishing a cat adopted from another organization
I am relinquishing a cat acquired from another person
I am bringing you a cat that I found
Where was this cat originally from?
*
When did you acquire this cat?
*
Please Select
Acquired less than 1 week ago
Acquired between 1 week and 2 weeks ago
Acquired between 2 weeks and 1 month ago
Acquired more than 1 month ago
Has this cat bitten anyone and broken the skin in the last 10 days?
*
Yes
No
Unsure
Has this cat ever seen a veterinarian?
*
Yes
No
What veterinary clinic/hospital has this cat been seen? Please be sure to include the specific location, if there are multiple locations.
*
Please include what year was this cat last seen at this clinic.
Please select all that applies to this cat’s physical condition:
*
Coughing
Sneezing
Diarrhea
Vomiting
Nose discharge
Eye discharge
Not eating
Skin issue
Injured
Other medical conditions
Healthy – no known medical conditions
Please tell us more about the physical condition's you selected above:
*
What brand/type of food does this cat currently eat? If a prescription diet, please indicate?
*
Is this cat currently on any prescription medications?
*
Yes
No
Unknown
Please list the names of the medications, dosages, frequency, method for giving, and any other information that would be helpful for us to know.
*
Has this cat ever had a dental cleaning, with or without extractions?
*
Yes
No
Second Cat's Information
Please upload a photo of the cat.
*
Browse Files
Drag and drop files here
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Cancel
of
Cat's Name
*
Cat's Gender
*
Male
Female
Unknown
Cat's Age
*
Kitten (0-4 weeks)
Kitten (5-16 weeks)
Adolescent (between 4 months and 1 year)
Adult (1-5 years)
Adult (6-9 years)
Senior (10-13 years)
Senior (14+ years)
Spayed or Neutered?
*
Yes
No
Unknown
Cat Origin:
*
I am returning a cat that was adopted from Feline Rescue
I am relinquishing a cat adopted from another organization
I am relinquishing a cat acquired from another person
I am bringing you a cat that I found
Where was this cat originally from?
*
When did you acquire this cat?
*
Please Select
Acquired less than 1 week ago
Acquired between 1 week and 2 weeks ago
Acquired between 2 weeks and 1 month ago
Acquired more than 1 month ago
Has this cat bitten anyone and broken the skin in the last 10 days?
*
Yes
No
Unsure
Has this cat ever seen a veterinarian?
*
Yes
No
What veterinary clinic/hospital has this cat been seen? Please be sure to include the specific location, if there are multiple locations.
*
Please include what year was this cat last seen at this clinic.
Please select all that applies to this cat’s physical condition:
*
Coughing
Sneezing
Diarrhea
Vomiting
Nose discharge
Eye discharge
Not eating
Skin issue
Injured
Other medical conditions
Healthy – no known medical conditions
Please tell us more about the physical condition's you selected above:
*
What brand/type of food does this cat currently eat? If a prescription diet, pleaseindicate?
*
Is this cat currently on any prescription medications?
*
Yes
No
Unknown
Please list the names of the medications, dosages, frequency, method for giving, and any other information that would be helpful for us to know.
*
Has this cat ever had a dental cleaning, with or without extractions?
*
Yes
No
Third Cat's Information
Please upload a photo of the cat.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Cat's Name
*
Cat's Gender
*
Male
Female
Unknown
Cat's Age
*
Kitten (0-4 weeks)
Kitten (5-16 weeks)
Adolescent (between 4 months and 1 year)
Adult (1-5 years)
Adult (6-9 years)
Senior (10-13 years)
Senior (14+ years)
Spayed or Neutered?
*
Yes
no
Unknown
Cat Origin:
*
I am returning a cat that was adopted from Feline Rescue
I am relinquishing a cat adopted from another organization
I am relinquishing a cat acquired from another person
I am bringing you a cat that I found
Where was this cat originally from?
*
When did you acquire this cat?
*
Please Select
Less than 1 week ago
Between 1 week ago and 2 weeks ago
Between 2 weeks and 1 month ago
More than 1 month ago
Has this cat bitten anyone and broken the skin in the last 10 days?
*
Yes
No
Unsure
Has this cat ever seen a veterinarian?
*
Yes
No
What veterinary clinic/hospital has this cat been seen? Please be sure to include the specific location, if there are multiple locations.
*
Please include what year was this cat last seen at this clinic.
Please select all that applies to this cat’s physical condition:
*
Coughing
Sneezing
Diarrhea
Vomiting
Nose discharge
Eye discharge
Not eating
Skin issue
Injured
Other medical conditions
Healthy – no known medical conditions
Please tell us more about the physical condition's you selected above:
*
What brand/type of food does this cat currently eat? If a prescription diet, please indicate?
*
Is this cat currently on any prescription medications?
*
Yes
No
Unknown
Please list the names of the medications, dosages, frequency, method for giving, and any other information that would be helpful for us to know.
*
Has this cat ever had a dental cleaning, with or without extractions?
*
Yes
No
Fourth Cat's Information
Please upload a photo of the cat.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Cat's Name
*
Cat's Gender
*
Male
Female
Unknown
Cat's Age
*
Kitten (0-4 weeks)
Kitten (5-16 weeks)
Adolescent (between 4 months and 1 year)
Adult (1-5 years)
Adult (6-9 years)
Senior (10-13 years)
Senior (14+ years)
Spayed or Neutered?
*
Yes
No
Unknown
Cat Origin:
*
I am returning a cat that was adopted from Feline Rescue
I am relinquishing a cat adopted from another organization
I am relinquishing a cat acquired from another person
I am bringing you a cat that I found
Where was this cat originally from?
*
When did you acquire this cat?
*
Please Select
Acquired Less than 1 week ago
Acquired Between 1 week ago and 2 weeks ago
Acquired Between 2 weeks and 1 month ago
Acquired More than 1 month ago
Has this cat bitten anyone and broken the skin in the last 10 days?
*
Yes
No
Unsure
Has this cat ever seen a veterinarian?
*
Yes
No
What veterinary clinic/hospital has this cat been seen? Please be sure to include the specific location, if there are multiple locations.
*
Please include what year was this cat last seen at this clinic.
Please select all that applies to this cat’s physical condition:
*
Coughing
Sneezing
Diarrhea
Vomiting
Nose discharge
Eye discharge
Not eating
Skin issue
Injured
Other medical conditions
Healthy – no known medical conditions
Please tell us more about the physical condition's you selected above:
*
What brand/type of food does this cat currently eat? If a prescription diet, please indicate?
*
Is this cat currently on any prescription medications?
*
Yes
No
Please list the names of the medications, dosages, frequency, method for giving, and any other information that would be helpful for us to know.
*
Has this cat ever had a dental cleaning, with or without extractions?
*
Yes
No
Fifth Cat's Information
Please upload a photo of the cat.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Cat's Name
*
Cat's Gender
*
Male
Female
Unknown
Cat's Age
*
Kitten (0-4 weeks)
Kitten (5-16 weeks)
Adolescent (between 4 months and 1 year)
Adult (1-5 years)
Adult (6-9 years)
Senior (10-13 years)
Senior (14+ years)
Spayed or Neutered?
*
Yes
No
Unknown
Cat Origin:
*
I am returning a cat that was adopted from Feline Rescue
I am relinquishing a cat adopted from another organization
I am relinquishing a cat acquired from another person
I am bringing you a cat that I found
Where was this cat originally from?
*
When did you acquire this cat?
*
Please Select
Acquired Less than 1 week ago
Acquired Between 1 week ago and 2 weeks ago
Acquired Between 2 weeks and 1 month ago
Acquired More than 1 month ago
Has this cat bitten anyone and broken the skin in the last 10 days?
*
Yes
No
Unsure
Has this cat ever seen a veterinarian?
*
Yes
No
What veterinary clinic/hospital has this cat been seen? Please be sure to include the specific location, if there are multiple locations.
*
Please include what year was this cat last seen at this clinic.
Please select all that applies to this cat’s physical condition:
*
Coughing
Sneezing
Diarrhea
Vomiting
Nose discharge
Eye discharge
Not eating
Skin issue
Injured
Other medical conditions
Healthy – no known medical conditions
Please tell us more about the physical condition's you selected above:
*
What brand/type of food does this cat currently eat? If a prescription diet, please indicate?
*
Is this cat currently on any prescription medications?
*
Yes
No
Please list the names of the medications, dosages, frequency, method for giving, and any other information that would be helpful for us to know.
*
Has this cat ever had a dental cleaning, with or without extractions?
*
Yes
No
Final Information
I certify that I am the owner of the cat and thus authorized to relinquish it to Feline Rescue.
*
Yes
No
I understand that I must be able to put this cat(s) in a carrier and bring it to Feline Rescue for us to consider it for Intake. Feline Rescue can provide a carrier for this purpose, if needed.
*
Yes
No
I understand that I must be able to bring this cat(s) to the intake appointment or have someone else bring it.
*
Yes
No
Submit
Should be Empty: