Please note: All animals must test negative for Ringworm before they can be accepted into our program. This form must be completed in order for your request to be processed. ONE REQUEST PER ADULT CAT PLEASE!
Is the animal over 5 months old?
Yes
No
First Name
*
Last Name
*
Best Phone Number
*
Email
*
Address
*
City
*
State
Please Select
Your State
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American Samoa
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District of Columbia
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Guam
Hawaii
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Indiana
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Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Montana
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New Hampshire
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New York
North Carolina
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Northern Mariana Islands
Ohio
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Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Number of kittens
Genders if known
Approximate Date of Birth:
-
Month
-
Day
Year
Date
How long have you been caring for the kittens?
Are the kittens eating solid food or nursing?
Nursing
Eating solid food
Are all the kittens from the same mother?
Please Select
Yes
No
Where did you get the kittens?
Would you like to participate in the Spay The Mom Program?
Please Select
Yes
No
Are the kittens social and used to be handled?
Do the kittens currently live outside?
Do the kittens use a litterbox?
Please Select
Yes
No
Do the kittens have any health concerns?
Please Select
No
Yes
Please explain health concerns:
Are the kittens on any medication?
Please Select
No
Yes
What medication?
Have the kittens been seen by a vet?
Please Select
No
Yes
Cat's Name:
*
Cat Gender:
*
Please Select
Select Option
Spayed Female
Neutered Male
Female unaltered
Male unaltered
Cat's Breed:
Cat's Age:
*
How long have you owned this cat?
*
Where did you get this cat?
Reason for surrender:
*
Has this cat ever bitten a person?
*
Please Select
Select Option
No
Yes
If yes, did it break skin?
Please explain the circumstances of the bite:
How does this cat interact with other cats?
*
Is the cat social with people and handle-able?
*
How does this cat respond to strangers or visitors?
*
Does this cat use the litterbox all of the time?
*
Please Select
Select Option
Yes
No
If no, please explain the circumstances when s/he does not use the litterbox:
Does this cat have any health concerns that need to be addressed?
*
Please Select
Select Option
No
Yes
If yes, please explain the concerns:
What is the name of your vet/clinic?
*
Has this cat been seen by a veterinarian in the past year for any reason?
*
Please Select
Select Option
No
Yes
Will you, the owner, be the one bringing the cat to Woods?
*
Please Select
Select Option
Yes
No
If no, who will be bringing the cat?
Please upload a photo of your pet here:
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