Your Email
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Cat's Name
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Cat's Nicknames
What would you want your cat’s new family to know about them?
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Cat's Age
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How long have you had this cat?
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Where did you get this cat?
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Please explain specifically what influenced your decision to surrender your cat:
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Can you tell us more about the characteristics you’ve selected & why you’ve selected them?
How old was your cat when you declawed it?
What have you provided your cat to scratch on?
When did the problem start?
Were there any changes in the household when the problem started? Example: moving, new baby, change of people in the house, new pets, remodeling, illness or death, guests, etc). If yes, please explain:
Last time litter boxes were moved or replaced:
Has your cat previously been diagnosed with a urinary tract infection? If yes, please list the last date of diagnosis and the symptoms your cat exhibited:
Has your cat had any issues with loose stool/diarrhea, bloody stools, or constipation? If so, please list last date of issues:
Where does your cat pee or poop inappropriately? Be specific and indicate if they poop and pee in different areas (next to box, on dirty laundry, on rugs, in corner of living room, in bathtub, etc.)
What do you use to clean the area?
What have you changed or done to try to fix the problem?
Has your cat been seen by a vet regarding the current problem? If yes, when, and what was the diagnosis?
Have you ever changed brands of litter? If yes, why?
What brand litter do you use?
Is there a part your cat does not like being touched? If yes, please explain:
How does your cat do in the car?
Who did the cat bite?
When was the last incident of a bite?
What part of the body did the cat bite?
What were the circumstances?
What are the ages of the children living in the household?
What are the ages of the visiting children the cat interacted with?
What ages of children would be best for your cat to live with, and why?
What age/size/breed of dog was your cat exposed to and for how long?
When we place your cat, do you think it would be happy in a home with dogs? If yes, what type of dog would be best?
If your cat has lived with other cats, what were the ages, genders and altered status of the other cats in the household?
Is the cat bonded to another cat? If yes, who?
Did your cat get along with the other cats? If no, why not?
What type of cat would be best as a companion to your cat?
Have you noticed any recent changes to your cat’s behavior or health (diarrhea, vomiting, lethargy, etc.)? If yes, please explain:?
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What clinic?
Whose name are the records under?
When was your cat last seen by your veterinarian?
Has your vet treated your cat for anything other than routine vet care? If yes, please explain:
Is your cat on any prescriptions or medications? If yes, please explain:
Is your cat on a prescription diet? If yes, which kind?
What kind of dry food has your cat been eating?
What kind and how often?
What kind/brand?
Have you ever changed brands of cat food? If so, when and why?
Is there anything else you would like us to know about your cat?
If you are human, leave this field blank.
