Name (required)
Street Address
City
State
ZIP Code
Phone
E-mail address (required)
Age
Describe in detail the cat you're looking for:
Will this be your first cat?
Yes
No
What kind of pets have you had in the past?
Which of these do you still have? Include age, sex and breed.)
Have they been spayed or neutered?
Yes
No
Don't know
Are they current on vaccinations?
Yes
No
Don't know
Have they been tested for feline leukemia?
Yes
No
Don't know
Have they been tested for FIV?
Yes
No
Don't know
Are they declawed?
Yes
No
Don't know
If yes, where is the cat declawed?
Front paws
All four paws
What happened to the pets you no longer have?
Have you ever turned your cat in to a shelter?
Yes
No
If yes, please explain:
Have you ever had a pet euthanized?
Yes
No
If yes, please explain:
If you have pets, will they adjust to a new cat in the house?
Yes
No
Don't know
Why do you want this cat?
Companion
Companion for other pet
House pet
Barn cat
Mouser
Office cat
Other
If other, please explain:
How many adults are in your household?
How many children?
Children's ages?
Does any member of your household have an allergy to cats?
Yes
No
Is someone home during the day?
Yes
No
If yes, who?
How many hours each day will the cat be without human companionship?
Please explain:
Where do you live?
House
Apartment
Condo
Mobile home
Other
If other, please explain:
Do you own or rent your home?
Own
Rent
If you rent, may we contact the owner to obtain permission for this cat to live in your home?
Yes
No
Owner's name and phone number:
Where will you keep the cat?
In the house
Outdoors
Free access both indoors and outdoors
In the barn
Please explain:
Do you have a cat or dog door?
Yes
No
Will you have the cat declawed?
Yes
No
Maybe
Are you aware of the potential side effects of declawing?
Yes
No
Will you keep the cat up-to-date on vaccinations?
Yes
No
Please give your veterinarian's name, address and phone number:
If you go away for a few days, or on a vacation, who will take care of the cat?
If you move, will you take the cat with you?
Yes
No
Have you ever applied to Pets Alive before to adopt an animal?
Yes
No
If yes, when?
Have you ever brought animals to Pets Alive?
Yes
No
If yes, please explain:
Are you willing to have a representative of Pets Alive come to see where the cat will be living?
Yes
No
If no, explain:
Are you willing to take responsibility of this cat for the next 10 to 20 years?
Yes
No
If no, explain:
What provisions will you make for the cat should you become unable to care for him/her?
How much are you willing to spend on medical bills for your cat?
Up to $100
Up to $500
Up to $1,000
Up to $5,000
Whatever it takes
What would you do if the vet bills went over this amount?
Any additional comments?
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