Cat Profile

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Cat Relinquishment Profile

The security code that you received when you had your telephone interview is required to submit this form. If you do not have the security code you cannot use this online form.

Cat's Name:
Sex:	Spayed or Neutered
Date of Birth:
Breed and Color:
How long have you had your cat?:
Why are you giving up your cat? Please be specific:
How did you obtain this cat?:
Does this cat use a scratching post?:	If so, what kind?: Carpet Upholstry Cardboard Sisal Fiber Wood Other
What types of items does your cat like to play with?:
How would you describe this cat's play style?:
Do you feel this cat is territorial?:	If Yes: Adults Children Dogs Cats
Cat spends most of it's time?:	Inside Outside
Outdoor information?:	Free to roam Confined to one area Supervised Unsupervised
Who has this cat lived with?:	Adult women Adult men Seniors Children (please give ages):
If this cat lived with children, please explain the daily interactions. Was this cat?:	Friendly Playful Cuddly Shy Fearful Aggressive
How does this cat react around?:	Cats: Dogs: Other:
What upsets this cat?:	Touching it's belly Touch paws Clipping Nails Other animals Cat carriers Being picked up Brushing Loud noises Strangers Bathing Other:
How does this cat behave for having it's nails trimmed?:
How would you describe your household?:	Active Quiet Noisy
How would you describe this cat overall?:	Friendly Playful Bossy Shy Easygoing Aloof Vocal Mouthy Mellow Destructive Fearful Cuddly Clingy Dislikes cats Dislikes dogs Dislikes children Independent
FOOD:
Prescription Food?:	How often?: Brand: Purchased at: Vet Store
Canned Food (Wet)?:	How often?: Brand:
Dry Food (Hard)?:	How often?: Brand:
Does this cat have any favorite treats?:	Yes, my cat enjoys:
Is this cat a picky eater?:	If yes, explain:
Does this cat have a sensitive stomach?:	If yes, explain:
LITTER BOX HISTORY:
Number of cats in the home:	Number of boxes in the home:
Type of litter box?:	Uncovered Covered Electric Other:
Type of litter?:	Non-clumping Clumping/Scoopable Other:
Brand?:	Scented Unscented
How often do you scoop the litter box?
How often do you dump and change out the litter?
How often do you wash and clean the litter box?
Where is the litter box kept in your home?
Has your cat ever had litter box problems?:	If yes, when was the last accident: Where?
Were these accidents?:	Urine Feces
How frequent were these accidents?
Was the problem resolved?
Was the cat ever taken to the Veteterinarian for this problem?:	If yes, what did they find?:
Please list any additional information about your cat's litter box history:
MEDICAL HISTORY:
How does this cat behave at the vet's office?
Is this cat declawed?:	Front Back At what age?
Name of this cat's veterinarian or clinic?:
Veterinarian address or phone:
Has this cat had routine vet care?:
Has this cat had any of the following health issues?:	Worms Weight Loss Hair Loss Sneezing Coughing Diarrhea Runny eyes Vomiting Bad teeth Bad ears Urinary Tract Infections Allergies Other
Were any of these conditions diagnosed/treated by a veterinarian?:	If yes, please explain:
Is this cat currently on any medications?:	If yes, please explain:
Has this cat been tested for?:	FeLV FIP FIV This cat has not been tested
At what age was this cat spayed/neutered?:	This cat is not fixed
Has this cat been microchipped?:
ADDITIONAL INFORMATION:
What do you like most about this cat?:
Please describe the ideal home for this cat:
After you have reviewed your profile please type the security code you received in the phone interview to setup an appointment::