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: *

Zip / Postal Code: *

Email: *

Phone *

Animal Info

Name: *

Age: *

Gender: *

Breed: *

Spayed/Neutered?

Reason for surrender: *

Where did you get this cat from? *

How long have you owned the cat? *

Is your cat litterbox trained? *

Is your cat declawed? *

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? *

What would be the ideal home for your cat? *