Cat Assistance Request and Profile
Thank you for taking the time to complete this questionnaire. The more details you provide, the better we can match your cat with the right adopter.
Name
*
First Name
Last Name
Title
*
Preferred Pronoun(s)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Preferred method of contact:
*
Please Select
Email
Text
Phone call
Any
What is the best time to contact you for additional information?
*
Note: A member of our team will contact you regularly during this program
Cat Information
Cat's name
*
Cat's nickname(s)
Age (or estimate)
*
if not known, please estimate
Date of Birth (if known)
*
Gender:
*
Breed (if known)
Coat Length
Domestic Short Hair
Medium Haired
Long Haired
Other
Color/Markings
*
Spayed or Neutered?
*
Please Select
Yes
No
Is your cat microchipped?
*
Please Select
Yes
No
Unknown
If microchipped, is it registered?
Please Select
Yes
No
Unknown
Veterinarian Name, Address and Phone number
*
Does your cat go to the vet for an annual exam? If no, please explain.
*
Is your cat up to date on vaccines?
*
Please Select
Yes
No
How long have you had this cat?
*
Where did you get the cat from, originally?
*
Has your cat ever lived outdoors or had an indoor/outdoor lifestyle?
*
Why are you looking for a new home for your cat?
*
Personality Overview
How would you describe your cat in 3 words?
*
Is your cat more:
*
Outgoing
Shy
Independent
Affectionate
Playful
Calm
Vocal
Other
How does your cat respond to visitors?
*
Friendly or curious
Cautious but warms up
Hides but will come out
Stays hidden
Other
How does your cat react to changes in the household such as new routines, new furniture, holiday decorations etc?
*
Medical Information
When was the last time your cat was seen by a veterinarian?
*
Can you provide updated or recent vet records for your cat?
*
Does your cat have any special needs or known medical conditions?
*
Is your cat currently on any medications? If yes, please list medicine, dosage and condition.
*
Any sensitivities to new food, stress or noise?
*
Daily Routine, Affection and Handling
Where does your cat sleep?
*
Does your cat wake you at night?
*
Please Select
Yes
No
Please list what food your cat eats and describe the feeding schedule:
*
What makes your cat the happiest?
What does your cat dislike?
*
Does your cat enjoy:
*
Being held
Sitting on laps
Being pet around ears and head
Being pet along back
Belly rubs
Being picked up
Being carried
Being brushed
Are there areas that your cat does not like to be touched?
*
Please elaborate on the area and what happens.
How does your cat show affection?
*
Does your cat tolerate nail trims?
*
Yes
With assistance
No
Other
Does your cat go into the carrier willingly?
*
Please Select
Yes
No
What is your cat's energy level?
*
Please Select
Low
Moderate
High
Favorite toys or activities:
*
Does your cat nip or scratch during play?
*
Yes
No
Behavior and Household Habits
Is your cat litter boxed trained?
*
Yes
Occasionally misses
Other
Back
Next
How many litter boxes do you have, what kind and what litter do you use?
*
Does your cat scratch:
Scratching pad/post
Furniture
Both
Has your cat ever sprayed or marked ? Please describe circumstances.
*
Any history of aggressive behavior such as biting or scratching? If so, please describe circumstances.
*
Has your cat ever lived with:
*
Cats
Dogs
Children under 5
Children over 6
Seniors
Other Species
Other
How does your cat behave with other cats?
*
How does your cat behave with dogs?
*
How does your cat behave with children of any age?
*
Does your cat prefer:
*
Being the only cat
Calm other pet as a companion
Multiple pets
Other
Ideal home
What type of home do you think would be best for your cat?
*
What would you want a new family to know about your cat?
*
Is there anything that makes your cat unique?
What is a funny story about your cat?
Please sign and date: I, the undersigned, attest that the information that I have provided is factual. I also understand the criteria required to participate in this program and agree to: 1) provide reliable transportation to veterinarian and adoption appointments, 2) keep my cat(s)until a new home is found, and 3) take financial responsibility for the necessary veterinary care.
*
Photos and Vet Records
If you have photos and/or vet records available, feel free to upload below. Thank you in advance.
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