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Name
*
First
Last
Address
*
City
*
State
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Zip Code
*
Age
*
Occupation
*
Phone number
*
Email address
*
Who are you interested in adopting?
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How many cats are you interested in adopting?
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Name of spouse/significant other?
*
Do you have any children? If yes, please list age
*
Do you have any roommates? If yes, please list name and age
*
Is everyone in the household aware you are interested in adopting a cat?
*
Does anyone have pet allergies in your home?
*
Who will be responsible for the cat?
*
Are you aware cats can live 15-20 years and are willing to take on this responsibility?
*
Why do you want to adopt a cat?
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Is this cat a gift? If yes, please explain *
*
This cat will be a… (Check all that apply)
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Companion
Companion for another pet
Barn cat
Mouser
House cat
Office cat
What type of home do you live in?
*
Single family home
Single family home
Townhome
Apartment
Condo
Do you rent or own your home?
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Rent
Rent
Own
How long have you lived at this address?
*
Do you have plans of moving in the future?
*
Yes
Yes
No
If you rent, are cats allowed?
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Yes
Yes
No
If you rent, please list the name and contact information of your landlord
*
In what areas of your home will your cat be allowed?
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Will the cat be indoor, outdoor, or both?
*
Do you have screens on your windows?
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Yes
Yes
No
Do you have a dog/cat door?
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Yes
Yes
No
How many hours will your cat be left alone? Please include hours during the pandemic and after
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Is this your first pet?
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Yes
Yes
No
Do your current pets live indoor, outdoor, or both? Please list each pet
*
Do you currently have any pets? If so, please list name, breed, and age of all pets
*
Are your pets current on their vaccinations?
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Yes
Yes
No
Are your current current pets fixed
*
Yes
Yes
No
If you currently have a cat, have they been tested for Feline Leukemia and FIV?
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Yes
Yes
No
Don't know
Will you keep your cat up-to-date on vaccines?
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Yes
Yes
No
Do you plan to declaw your cat?
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Yes
Yes
No
Have you had pets in the past? If so, please list name, breed, age and why you no longer have them
*
Were you ever in a situation you could not keep your pet? If so, please explain
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In the event you are no longer able to care for your cat, who will be responsible for their care? Please include name, relationship, and contact information
*
What kind of food will you feed your cat? Please include brand
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What kind of litter will you use? Please include type
Will your cat wear a collar? If so, what kind?
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What precautions will you take when introducing the new cat to your current pets?
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Are you okay with a home check?
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Yes
Yes
No
Name of Veterinarian
*
Veterinarian’s Phone
*
Veterinarian’s Address
*
If a disciplinary or behavioral problem arises, what will you do?
*
Is there anything else you would like us to know?
How did you hear about us?
*
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