Surrendering your Cat Surrendering Your Cat Instructions: Please fill out the following information with as much detail as possible. Please be as specific as possible when describing behavioral concerns. This information will assist us in creating an appropriate shelter training/enrichment plan, meeting your animal’s needs while in our care and finding your cat an appropriate home.*Name* First Last Phone*Email* Enter Email Confirm Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Cat's Name*Cat's Sex* Male Female Age or birth date (if known)*Breed - if known*Weight*Is your cat spayed/neutered?* Yes No Current on vaccinations?* Yes No If Yes - date(s) of recent vaccinationsName and phone number of veterinarian*List and past or present medical issues*Date and reason for last vet visit.*Microchipped* Yes No If Yes - microchip providerWhy are you surrendering this cat?*How long have you had this cat?*Where did you get this cat?** Indoor Outdoor Indoor/Outdoor Does your cat use a doggie door? Yes No Has this cat ever broken a person's skin with his/her teeth?* Yes No If Yes, please describe the situation.Describe how your cat plays with other cats.*Do you use, or have you ever used, a cat carrier for this cat?* Yes No How does the cat react to being put in a carrier?List all other pets (species) this cat has lived with and describe their behavior and your concerns, if any.*Has this cat been around children?* Yes No If Yes, please list children's ages and the cats interaction.Has this cat ever injured another animal?* Yes No If Yes, please describe the incident.What are this cat's favorite games/toys?*Is this cat bonded to another pet?* Yes No If Yes, please describeBrand of food and feeding routine*Is this cat allowed on the furniture, counters, tables, beds, etc.? Describe any restrictions.*What causes this cat to be nervous, fearful, assertive, or unsure?*How does this cat react when people come to your home to visit?*What areas of this cat's body does she/he NOT like you to touch? What is the reaction?*Does this cat use a litter box?* Yes No How many house-soiling mistakes does your cat make each week?*If you could change something about this cat's behavior, what would it be?*What do you think would be the ideal home for this cat?*If you were placing an ad to re-home this cat, what would it say about him/her?*Please provide any other information that you feel would be helpful to a future caregiver and/or would assist a shelter in finding a home for this cat. This iframe contains the logic required to handle Ajax powered Gravity Forms.