Furvana Cat Rescue Surrender Form
Intake is by appointment only and subject to space availability. Submission of this form does not guarantee immediate intake.
Full Name:
Phone Number:
Email Address:
Home Address:
Cat's Name (if known):
Approximate Age:
Sex:
Male
Female
Unknown
Spayed/Neutered:
Yes
No
Unknown
Microchip:
Yes
No
Unknown
If yes, list number:
Color/Markings:
Found Outdoors?
Yes
No
If yes, list location found:
Medical History (if known):
Behavior:
Friendly
Social
Fearful
Aggressive
Shy
Behavior Notes:
All relevant veterinary records, vaccine history, and medication history must be provided at the time of surrender. Please upload any records here or email to nicole@furvanacatrescue.org
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Submit photo(s) of cat
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Has this cat ever shown unprovoked aggression toward a person or animal and caused injury?
Yes
No
If yes, describe incident(s):
Relationship to Cat (check one):
Legal Owner
Finder (Community/Stray Cat)
Authorized Representative
Other:
By typing your name below, you permanently and irrevocably surrender all ownership rights to Furvana Cat Rescue. Furvana Cat Rescue retains sole discretion regarding medical care, foster placement, adoption, TNR return, transfer, or humane euthanasia if necessary. This surrender is voluntary and final.
Printed Name:
Date:
-
Month
-
Day
Year
Date
Notes:
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Should be Empty: