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Sample Shelter Forms
- 1. Cat Adoption Application
- 2. Dog Owner's Questionnaire (Relinquishment Profile)
- 3. Pet/Livestock Adoption Application
- 4. Dog Adoption Application
- 5. Cat Owner's Questionnaire (Relinquishment Profile)
- 6. Adoption Discussion Card - Dog
- 7. Reptile/Amphibian Animal Adoption Application
- 8. Questions to Review by Public Officials and Concerned Citizens
- 9. Adoption Discussion Card - Cat
Cat Owner's Questionnaire (Relinquishment Profile)
Marin Humane Society
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Cat Owner's Questionnaire
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Cat's Name: ______________ Breed: ___________ Age: _______ Sex: ________
To enable us to find the best possible home for this cat, please fill in the information below as completely and accurately as possible.
Why are you giving up this cat? _______________________________________
How long have you owned this cat? ____________________________________
How many owners has this cat had? ____________________________________
Where did you get this cat? ___________________________________________
Name of cat's veterinarian? ___________________________________________
What types of pets did this cat live with? ____________________________
Please describe any conflicts with this cat and the other
pets? ________________
_________________________________________________________________
List ages of any children in household. __________________________________
Please describe any conflicts between this cat and children. __________________
_________________________________________________________________
Where did this cat spend most of its time?
Indoors onlyr Mostly indoor r In Garage r Mostly outside r Always outdoors r
Where was the litterbox kept? ____________________________________
How many cats shared this litterbox? ______________________________
How often does your cat urinate or defecate outside the litterbox? ________
Give example _________________________________________________
What kind of litter do you use? ____________________________________
How often do you change the litter? ________________________________
Is your cat declawed? ______________ If so, why? ____________________
Does your cat use it's claws on furniture or drapes? _____________________
Does your cat use a scratching post? ______ If so, what type? ____________
Where was it kept? _____________________________________________
How often was this cat brushed or groomed? ________________________
Describe any problems with grooming? _____________________________
How often does this cat get hairballs? _______________________________
How often does the cat spray? ____________________________________
When and where? __________________________________
Have you ever consulted a trainer or behaviorist on any problems concerning this cat? ____
Describe problem ________________________________________
What form of discipline or correction do you use with this cat? _______________
How does the cat react? _____________________________________
Has this cat ever bitten or scratched anyone? No r Yes r
Describe incident ________________________________________
Please describe any health problems this cat has? _________________________
Is the cat on any medications? _____________________________________
If so, please list? _______________________________________
What form of flea control do you use? _______________________________
Please describe your cat's idea of a perfect day?
_________________________
______________________________________________________________
Check as many of the following that describe your cat's behavior.
Outgoing r Friendly r Affectionate r Independant r Relaxed r Playful r Slow to Adjust r Lap Cat r Shy r Talks r
Is there anything else we should know about this cat? _______________________
_______________________________________________
Courtesy of
171 Bel Marin Keys Blvd.
Novato, CA 94949
(415) 883-4621
(415) 382-1349 fax
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For Shelters: Sample Shelter Forms:
Adoption Discussion Card - Dog
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