Cat Owner Surrender Appointment Request

Cat Owner Surrender Appointment Request
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
CAT'S INFORMATION
Reason for Surrender*

Behavior - Animal AggressionBehavior - Human AggressionBehavior - BitesBehavior - ScratchesBehavior - FearfulBehavior - Potty Training/Litter BoxBehavior - OtherCost of Care - MedicalCost of Care - SuppliesEvictionLandlordMovingOwner HealthOther
Please provide more detailed information on your reason for surrendering your pet*
How did you obtain this pet?*

Adopted from The Animal FoundationAdopted from other shelter or rescue organizationBred at homeFound a lost animalGift from family member or friendPurchased from pet storePurchased from breederPurchased from social media/other sourceRehomed by previous ownerOther
Please provide more information on how you obtained this pet:*
Cat Name*
Where does the cat live?*

IndoorOutdoorBoth
Is the cat declawed?*

YesNoFront-onlyAll 4 Paws
How long have you owned this cat?*
How old is your cat?*
Is the cat litter box trained?*

YesNo
Type(s) of litter used*

ClumpingPineNot sureNon-clumpingNewspaperUnscentedScentedClayCrystals
Food Preference*

WetDry
Brand
Type(s) of food used*

WetDryBoth
How often is cat fed each day?*

1-3/day4+/dayFree feed
Are there any food allergies or things that upset the cat's stomach?*

YesNo
If yes, explain
Does the cat get along with*

newborn to age 5children, ages 5-12teenagerall
Personality and Lifestyle
Indicate behavior habits (check all that apply):*

Vocal/talks a lotLikes being picked upLap catNips, love/playQuietBitesFriendly to visitorsShyLikes pettingIndependentLikes BrushingAffectionatePlayfulChases insectsEscapes out doorway
Indicate favorite things (check all that apply):*

CatnipLaser pointerHigh places/perchesWand ToysJingle ballsOther animalsTreatsCrinkle toysWindowsillsToy mice
How does this cat react to new people?*

ShyFriendlyNo reactionRun awayOther
How long does this cat take to adjust to new situations or people?*

HoursDaysWeeksOther
Home Life
What areas of the home did this cat have access to? (check all that apply):*

Whole houseOutdoors onlyAnywhere people areKitchenShedDoggie doorLiving roomBathroomGarageBedroom
Has this cat lived with other cats? (check all that apply):*

NoOther cat maleOther cat femaleNap by each otherSniffed nosesPlayed togetherAdored other catIgnored other catPeaceful coexistGroomed each otherDid not like each otherFights other catAvoided each otherKept separate
Has this cat lived with dogs? (if yes, check all that apply):*

NoAdored each otherIgnored each otherAvoided each otherPlayed togetherPeaceful coexistNap by each otherSniffed nosesCat rubbed on dogGroomed each otherCat feared dog
Would you recommend that this cat be placed in a home with other animals? (check all that apply)*

NoYesPocket petsLarge dogSmall dogsCatsOther
If checked no, please explain
Medical History & Behavior Towards A Veterinarian:
Does it have a regular Veterinary Hospital?*

YesNo
If yes, please explain
Does this cat have to be restrained at the vet?*

YesNoNot applicable
How does this cat behave during visits to the vet?*
Has your pet ever been sick in the past?*

YesNo
If checked yes, please explain
Is this cat taking any medication or has it been prescribed medication by a veterinarian in the past?*

YesNo
If yes, please explain
Has this cat ever had surgery other than spay/neuter?*

YesNoDon't know
If yes, please explain
Is there anything you want a new family to know about this cat’s interaction with (men, women, children, dogs, cats, other)?*

YesNo
If yes, please explain
Please tell us about the cat's unusual behavior or fears:*
Are there any wonderful, special traits or habits that you would like his/her new family to know about?*

YesNo
If yes, please explain
Please read the following statement prior to signing:

I understand I am forfeiting any rights to this pet to The Animal Foundation (TAF) and that this animal could have any of the following outcomes: Return To Home (for community cats), Adoption, Transfer to a Paw Partner, or Humane Euthanasia if deemed necessary.
Please upload a copy of your ID*

Cancelof
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Cat Owner Surrender Appointment Request

CAT'S INFORMATION

Personality and Lifestyle

Home Life

Medical History & Behavior Towards A Veterinarian: