Skip to main content
Vet Clinic Donate
Donate

Cat surrender form

To enable us to find the best possible home for your cat, please fill in all fields as completely and accurately as possible.

Did you get your cat from another shelter, rescue group, store or breeder? 
Does your cat have a microchip? 
Including yourself, how many people in each of the following age groups live in your house?
Male Member(s) of Household Quantity  
Age 0-3Age 4-9Age 10-17Age 18-29Age 30+
Female Member(s) of Household Quantity  
Age 0-3Age 4-9Age 10-17Age 18-29Age 30+
Household Information
Has your household experienced any recent changes?
Has your cat ever spent time around children under 10? 
How would you describe your cat's behavior with children under age 10? (Check all that apply.) 
Has your cat ever lived with other cats? 
If your cat has ever lived with other cats, how did they interact? (Check all that apply.) 
Has your cat every lived with dogs? 
If your cat has ever lived with dogs, how did they interact? (Check all that apply.) 
Where does your cat spend his/her time? 
Behavior Information
How would you rate your cat’s energy level?  
How would you describe your cat most of the time? (Check all that apply.)
How does your cat react when uncomfortable?
How long does it take your cat to acclimate to new situations or people?
Tell us a little about your cat’s people preferences. (Check all that apply.)
Does your cat use a scratching post?
How does your cat like to play? (Check all that apply.)
Please Indicate ALL Known Behavior Traits. (Check all that apply.)
Medical background
Has your cat ever been to a veterinarian? 
How does your cat react to the veterinarian?
Is your cat sensitive about being touched?
Does your cat have any past or present medical concerns? 
Is your cat on any medications? 
Dietary Information
What do you feed your cat? (Select all that apply)
Would you describe your cat as a picky eater?
Litter box history
What type(s) of litter boxes do you use? 
What approximate size is the litter box?
Has your cat ever urinated or defecated outside of the box?
Which of the following has your cat done?  
How often does this inappropriate elimination occur?
Are the accidents near the litter box?
Have you taken any of the following measures to correct the problem? (Check all that apply.)
Have you ever taken this cat to a veterinarian to rule out medical issues or infection regarding inappropriate litterbox habits?
In your multi-cat household, what was the litterbox setup?
These are a few of my favorite things…
Please indicate your cat's favorite things. (Check all that apply.)