Cat Owner Surrender Form If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Date: * First Name: * Last Name: * Street Address: * City: * State: * 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 Zip / Postal Code: * Email: * Phone * Animal Info Name: * Age: * Gender: * MaleFemale Breed: * Spayed/Neutered? YesNo Reason for surrender: * Where did you get this cat from? * How long have you owned the cat? * Is your cat litterbox trained? * YesNo Is your cat declawed? * YesNo Does your cat have any medical conditions? If so, please explain: * Veterinarian name and phone number: * Is your cat up to date on all vaccinations? * Has your cat ever scratched or bitten anyone? If so, please explain: * What is your cat’s energy level? * Does your cat like children? If so, what age? * Is your cat destructive to furniture or belongings? If so, when does the destruction occur? * Would you describe your cat as submissive or dominant? * Does your cat get along with other cats? Dogs? * Does your cat have any aggression issues? * List of genders and ages of people living with the cat now: * How does your cat react to the people it lives with? * How does your cat react to visitors at your home? * Is this your first cat? * YesNo What would be the ideal home for your cat? *