Pre-Adoption Questionnaire

This purpose of this form is to evaluate candidates wishing to adopt a pet, and to find the best possible match ...We reserve the right to deny any application and to share information with other animal welfare organizations.

Which Feline(s) are you interested in?

About yourself:

Last name:		First name:
Address:		City:
State:	Zip/Postal	Home Phone:
		Work Phone:
Email:		DL#

1. What is your primary reason for adopting a cat?
A companion for: you; housemate ; your children; other pet;
A gift; Other:

2. Who shares your household?
Spouse; Significant Other; Roommate; No one;
Children (ages ); Other

3. Are all members of the household aware of, and in agreement with owning a cat? Yes; No.

4. Type of dwelling: House; Apt.; Condo.; Other
If you live in an apartment/condo, what floor?

5. Do your doors/windows have screens? Yes; No; If yes, how old are the screens?

6. Do you have a "dog door"? Yes; No

7. Are you legally permitted to have cats where you live? Yes; No; Don't know.
Landlord Contact Number

8. About how many hours will the cat be left alone each day?

9. Who will be responsible for the care of the cat?

10. Where will the cat sleep?

11. Will the cat be: Indoor only; Indoor/Outdoor; Outdoor only.

12. Do you plan to ever have the cat surgically declawed? Yes; No; Maybe.

13. How will you discipline the cat for misbehaving?
Use newspaper; Spank; Swat nose; Stern voice; Squirt with water;
Other

14. How long do you plan to keep the cat you wish to adopt?

15. What do you think the normal life span of a cat is?

16. Do you consider a cat a pet; a member of the family; both?

17. Under what circumstances might you not keep the cat?      Shedding;      Move;
        Furniture clawing;     New housemate;     New baby;      Litterbox problems;
        Allergies;      New Relationship;    Pregnancy;    None of the Above;      Other

18. Do you plan to feed your cat: Canned food only; Dry food only; Both.

19. Do you plan to buy: Grocery store brands; Pet store brands; Both.
Which brand(s) do you plan to feed the cat that you adopt?

20. Do you have a vet? Yes; No; Name and Phone Number: :

21. Are you willing and able to provide quality medical care;
(i.e. yearly vaccinations, treatment for illness or injury)? Yes; No.

22. Have you ever owned a cat? Yes; No .

23. If Yes, what is the current status of the cat?

24. If deceased, at what age and from what?

23. Do you have other pets now? Cat; Dog; Bird; Other

24. If you currently have pets, are they spayed and neutered? Yes; No; Not applicable.

25. If you currently have pets, are they Indoor Only ; Indoor/Outdoor; Outdoor only

26. Please provide the names and phone numbers of three references: ; ;

27. Would you object to a home visit by one of our volunteers? Yes; No .