Pre-Adoption Questionnaire

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Cat Pre-Adoption Questionnaire

The 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.

All fields in white are required

Which Feline(s) are you interested in? Invalid Input

About yourself:
First Name	Invalid Input	Last Name	Invalid Input
Address	Invalid input	City	Invalid Input
State	Invalid Input	Zip/Postal	Invalid Input
Home Phone	Invalid Input	Work Phone	Invalid Input
Your Email	Invalid Input	Driver's License #	Invalid Input

1. What is your primary reason for adopting a cat? Invalid Input
Other	Invalid Input

2. Who shares your household?
	Spouse Significant Other Roommate No-one Children Other Invalid Input	Children's Ages	Invalid Input
		Other	Invalid Input

3. Are all members of the household aware of, and in agreement with owning a cat? YesNo Invalid Input

4. Type of dwelling:	Invalid Input	Other	Invalid Input
If you live in an apartment/condo, what floor?		Invalid Input

5. Do your doors/windows have screens? YesNo Invalid Input		If yes, how old are the screens? Invalid Input

6. Do you have a "dog door"? YesNo Invalid Input

7. Are you legally permitted to have cats where you live?
YesNoDon't know Invalid Input		Landlord Contact Number	Invalid Input

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

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

10. Where will the cat sleep? Invalid Input

11. Will the cat be: Indoor onlyOutdoor onlyIndoor/Outdoor Invalid Input

12. Do you plan to ever have the cat surgically declawed? YesNoMaybe Invalid Input

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

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

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

16. Do you consider a cat a peta member of the familyboth Invalid Input

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 Invalid Input	Other	Invalid Input

18. Do you plan to feed your cat Canned food onlyDry food onlyBoth Invalid Input

19. Do you plan to buy Grocery store brandsPet store brandsBoth Invalid Input
Which brand(s) do you plan to feed the cat that you adopt? Invalid Input

20. Do you have a vet? YesNo Invalid Input
Name and Phone Number of vet Invalid Input

21. Are you willing and able to provide quality medical care? (i.e. yearly vaccinations, treatment for illness or injury)? YesNo Invalid Input

22. Have you ever owned a cat? YesNo Invalid Input

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

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

25. Do you have other pets now?
	Cat Dog Bird Other Invalid Input	Other pet	Invalid Input

26. If you currently have pets, are they spayed and neutered? YesNoNot Applicable Invalid Input

27. If you currently have pets, are they Indoor onlyIndoor/OutdoorOutdoor only Invalid Input

28. Please provide the names and phone numbers of three references:
Name	Invalid Input
Phone	Invalid Input
Name	Invalid Input
Phone	Invalid Input
Name	Invalid Input
Phone	Invalid Input

29. Would you object to a home visit by one of our volunteers? YesNo Invalid Input

Make sure you are a human. Please enter the numbers in the field Refresh Invalid entry. Try refreshing the box for a new code.