CAT DOSSIER FORM (ALL INFORMATION PROVIDED WILL REMAIN PRIVATE) Your Name Your Age. Address. City, ST, Zip Phone. Alt. Phone

Similar documents
INCOMING CAT PROFILE

OWNER SURRENDER CAT QUESTIONNAIRE

Pet Personality Profile

Pooch Personality Profile

DuPage County Animal Care & Control Cat Behavior & Health Profile

Cat Surrender Profile

Cat Profile. Animal ID (Staff Use Only) Cat s Name: Breed: Spayed or Neutered: (Check Box) Yes No Unknown Age: Date of Birth (If Known):

PLAY ALL DAY, LLC REGISTRATION FORM

Feline Intake Profile

CANINE SURRENDER PROFILE

Metro Dog Day Care and Boarding Program Application

310 Carver Lane, East Peoria, IL Phone: (309) Fax: (309)

Behavioral History for Consultation Connecticut Humane Society Newington Branch Fax:

Dog Profile for Behavior Evaluation

Owner Relinquish Profile - Cats

Ellen M. Lindell, V.M.D., D.A.C.V.B Telephone (845) / Fax.(845) P.O. Box 1605, Pleasant Valley, NY

Daycare Application Form

Incoming Dog Profile

MASSACHUSETTS HUMANE SOCIETY INC.

Off-Leash Play Application

Mile High Weimaraner Rescue Surrender Packet

Cat Behavior Questionnaire

CAT/KITTEN SURRENDER PROFILE FORM Completed form must be submitted at scheduled surrender appointment. Contact Information (*Required):

History Form This form is not a comprehensive history form, but a general guide for history

Cat Behavior History Questionnaire

ADOPTION APPLICATION INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

Please visit for more information and lots of wonderful behavioural tips!

Tug Dogs Canine History Form

Cat Surrender Profile

TRAINING & BEHAVIOR QUESTIONNAIRE

1740 W. Gordon St., Valdosta, GA ADOPTION CONTRACT PET INFORMATION

Strengthening the Human Animal Connection

1 FELINE BEHAVIOR CONSULTATION QUESTIONNAIRE GENERAL INFORMATION PET INFORMATION ENVIRONMENT / LIFESTYLE

German Shepherd Rescue of New York, Inc. P.O.Box 242, Delmar, NY

Cat Owner Questionnaire

Incoming Dog Profile Revised 3/23/2016

Connecticut Humane Society Canine Pet Personality Profile

BEHAVIOR QUESTIONNAIRE FOR CATS

Pet Name: Color Breed Female Male Est. DOB Age: Date Next Annual Vaccine Due: MicroFinder Chip No.

Dog Adoption Application Form

All dogs are spayed/neutered before placing, current on vaccinations, and are micro-chipped.

Owner Surrender Intake Interview Form

BEHAVIOR QUESTIONNAIRE FOR DOGS

Animal s Name F/M. Does your cat have any pre-existing or current medical problems? Yes No If yes, please describe

Adoption Application. Your Name. Are you 21 years of age or older? Yes No. Address. City State Zip. Home Phone # Work # Cell #

Surrendered Cat Information Date:

Sylvan Lake & Area Serenity Pet Shelter Adoption Application Form

BEHAVIOR QUESTIONNAIRE FOR CATS

God s Grace Canine Rescue, Inc. Adoption Questionnaire. Your Name: Address: Home Phone: Cell Phone: Employer: Work Phone:

Music City Greyhound Adoption Foster Application

Rocky s Retreat Boarding/Daycare Intake Form

Foster Home Application and Contract

FELINE BEHAVIOR CONSULTATION QUESTIONNAIRE

Feline Behavior Questionnaire

Please complete and return this questionnaire for private lessons. or posted to PO Box 248, Ourimbah, 2258.

DOG ASSESSMENT FORM. In addition to completing the form from owner responses include your own observations wherever possible. Assessment.

FELINE SURRENDER AGREEMENT

BEHAVIOR QUESTIONNAIRE FOR DOGS

Walton Salley Corgis and Friends of Walmarsh. Adoption Coordinator, Edith Stull

APPLICATION & CONTRACT TO ADOPT

Total number of children in your home: Ages of children:

CANINE BEHAVIOR HISTORY FORM. Household Information. Pet Info. List all other family members (names): Adults: Children: age age

Day Care & Overnight Stay Enrolment Form

RE-HOMING PACKET. Dear Pet Guardian: Enclosed is a packet of information to help you re-home your pet(s). You should find the following:

In Home Service/ Hearing/ Companion Dog. In Home Service/ Hearing/ Companion Dog Questionnaire

South Paw Doggie Daycare & Training Center

ROVER lindblade street culver city, ca t f (Please Print Clearly) Owner s Name ::

Paw Paw s Pets 3124 Broad Avenue Memphis, TN

FELINE BEHAVIOR CONSULTATION QUESTIONNAIRE

Canine Enrollment Form

Owner Liability Waiver and Health Certification

THE BOXER TRANSFER NETWORK

Small Paws-Big Hearts

Foster Home Application

S.A.R.G. DOG ADOPTION APPLICATION / CONTRACT

Payment Is Due At The Time Of Services Are Rendered. We Accept Cash, Local Checks, and All Major Credit Cards

Cat Surrender Information & Profile

VOLUNTEER INFORMATION

Cat/Kitten Adoption Application

New Client Information

Emergency Contact Name Address Home phone Cell phone

Total number of children in your home: Ages of children:

Animal House Sanctuary We don t just find homes, We find Families

MEMBERSHIP APPLICATION

LITTLE TRAVERSE BAY HUMANE SOCIETY CAT ADOPTION POLICIES AND APPLICATION

Adoption Application

CAT ADOPTION APPLICATION

Virtual Shelter Project You Can Save Your Pet s Life Without A Shelter.

The Official Dog Walkers and Pet Sitters

Age: Primary caretaker of dog: Other dogs in home (name, breed, sex, spayed/neutered), please list in order obtained:

Cat Adoption Questionnaire

ADOPTION APPLICATION

Barn Cat Adoption Agreement

City, State: (Male/Female; Adult/Kitten (under 5 months); Long Hair/Short Hair)

Dog Surrender Profile

LITTLE TRAVERSE BAY HUMANE SOCIETY CAT ADOPTION POLICIES AND APPLICATION

Are you applying to another rescue in this state, if so, which? Are you applying for another pet on the SPAY-LEE website? If so, which one/s?

HART Hoopeston Animal Rescue Team

Owner/Guardian SURRENDER Contract

Daycare & Sleepover Registration Form

Transcription:

CAT DOSSIER FORM Thank you for taking the steps to enroll your cat in the Hearts That Purr Feline Guardian program. Our program is designed to ease the transition from a cat s familiar home into our care after the death or incapacitation of its owner. We understand the reason you are taking this step is because you love your cat very much and wish to ensure the continuation of his or her care should you no longer be here to do so yourself. We want you to rest assured knowing that by joining our family of Feline Guardian Program enrollees, your cat s happiness, comfort and safety will be our highest priority and all decisions regarding your cat will always be made with the best interest of your cat as an individual and your wishes in mind. Unless an ideal adoptive home is found, our organization utilizes high-quality group and foster homes to provide your cat a lifetime of loving care in as close to the residential environment he or she had with you. Letting us know as much about your cat, especially with regard to behavior and medical issues, will greatly help us to help them adjust to their life without you. Therefore, please answer the following questions about your cat in as much detail as possible and feel free to add additional information as you like to help us know your cat better. If you do not know the information requested, leave it blank. If you have any questions, please call us to discuss them. Finally, please attach a photo of your cat with the Cat Dossier Form. (If you do not have one to spare, you may email a digital image to us at heartsthat@outlook.com. 1

CAT DOSSIER FORM (ALL INFORMATION PROVIDED WILL REMAIN PRIVATE) Your Name Your Age Address City, ST, Zip Phone Email Alt. Phone Are you the sole owner of the cat being enrolled? Yes No If not, please list the name(s) of any other person who shares ownership and how you are related to them? Are you enrolling your cat in The Feline Guardian Program for future peace of mind or do you have a current health concern that may necessitate your cats coming to live at our sanctuary in the immediate future? (We apologize for inquiring about this personal information; however, it is important. One of the characteristics that set Hearts That Purr apart from other feline sanctuaries is our policy of maintaining a low resident population of felines. Because cats enrolled in the Guardian Program are guaranteed immediate entry, we must be aware of the potential for a cat(s) arriving sooner than expected when that information is available to us. This information helps us in planning the number if new Feline Guardian Program enrollees, as well as any new cats we can rescue from the community from time to time.) 2

YOUR CAT S INDENTIFICATION Cat s Name: Age Male Female Is your cat spayed or neutered? Yes No Is your cat declawed? Yes No If Yes, specify: front all paws Breed Color How long have you owned this cat? Where did you obtain your cat? Breeder Pet store Friend Stray Other Shelter/Rescue group Is your cat micro-chipped? Yes No If Yes, what is the ID # Company YOUR CAT S HEALTH Name of Veterinarian Last visit Is your cat current on its vaccinations? Yes No If Yes, please include current vaccination certificates with biography form. If No, you must have this done prior to enrolling your cat in our program. Has your cat ever been tested for Felv or FIV Yes No If Yes, what were the results? Felv? FIV? If No, you will need to have your cat tested prior to enrollment in the program. 3

Does your cat have any current, previous or recurring medical or behavioral problems? Yes No If yes, describe What medication (including vitamins or supplements) is your cat currently taking? YOUR CAT S LIFESTYLE Please list the predominant ages and gender of people your cat is used to living with How does your cat react to strangers or visitors? Hides most of the time Growls/Hisses Allows petting Ignores them Plays well Gentle/affectionate Is interested, but distant Other Please tell us what other animals your cat has lived with: Male cat(s) un-neutered # Male cats(s) neutered # Female cat(s) un-spayed # Female cat(s) spayed # Dogs # Other Never lived with other animals 4

How does this cat react to other cats in your home or outside of your home? Bullies Frightened Friendly/Playful Never around other cats Shy Growls/hisses Curious Ignores Unknown Other Is your cat litter box trained? Yes No Goes outdoors What brand of litter does your cat prefer? Has your cat ever inappropriately eliminated or sprayed? Yes No If Yes, describe: On the floor On the wall On furniture On people Other Can you recall if there was any reason or situation that triggered this behavior? Is there anything unusual about your cat s toilet habits that we should be aware of? 5

Where does the cat primarily reside? Inside only, with no protected outdoor area Inside only, without protected outdoor area Inside/Outside Outside only What toys or games does your cat like to play? How many hours a day is your cat left alone? More than 10 hours 8-10 hours 5-8 hours 0-4 hours Never left alone Other Do you regularly travel? Yes No If Yes, do you use a pet sitter? Yes No Name and number of sitter Do you ever board your cat? Yes No If Yes, where? Do you have your cat professionally groomed or bathed? Yes No Where? If you attend to your cat s grooming needs yourself, please describe any special processes or products you have used 6

How would you describe your home environment? Very quiet with few to no visitors. Moderately social with regular visitors of small groups at a time. I have an active social life and entertain large groups frequently in my home. I have children or other animals visit my home on occasion. What circumstances or situations should be avoided that may cause your cat to be stressed? Does your cat have a tendency to nip, scratch or bite? Yes No Explain situations that trigger this behavior Has your cat ever bitten you or someone else? Yes No If Yes, please describe when and what happened? What part(s) of your cats body does he/she not like touched? Feet/Legs Back area Head/Face Tail area Chin/Neck Belly Other 7

FEEDING INFORMATION What brand and type of food have you been feeding your cat? Wet/canned: Dry: At what times of the day do you feed your cat and the amount per meal? Wet (canned) food: When? Amount per meal? Dry food: When? Amount per meal? What type and brand of treats does your cat enjoy? FOR MULTI-CAT HOUSEHOLDS If you are enrolling more than one cat in the Guardian Program, what is/are the name(s) of the other(s): Is your cat part of a bonded pair you d like to remain together? Yes No If Yes, what is the name of the other cat in the bonded pair? Describe the relationship of your bonded kitties 8

Do your cat fight with another in your household? Yes No If Yes, please provide the name of your cat s nemesis and describe the relationship Have you previously tried any behavior modification remedies or medications to try to resolve your cat s differences with the other cat? Yes No If Yes, what did you try, when did you last try it, and what were the results? Do you keep these cats separate in your home now? Yes No If Yes, describe the living arrangements 9

SUPPLEMENTAL INFORMATION Is there other information about your cat that you would like us to be aware of? (Use additional pages if necessary.) The foregoing information is accurate to the best of my recollection and will be used by Hearts That Purr Feline Guardians as a resource regarding the future care of my cat. I ll try my best to provide updated information if anything changes in the future. I understand that if my cat enters the care of the Guardian Program at some time in the future, Hearts That Purr will use this information as a guide; however, may make adjustments or modification when doing will be in the best interest of my cat. This information is regarding my cat named Signature of Cat Owner Date Signature of Cat Owner Date Received by Hearts That Purr Feline Guardians Date 10