LOADING...
Please wait.
P.E.T.S CAT ADOPTION QUESTIONNAIRE
*CATS NAME OF INTEREST
BREED AND COLOR OF CAT
*WHERE DID YOU FIRST HEAR ABOUT THIS CAT?
Choose a WHERE DID YOU FIRST HEAR ABOUT THIS CAT?
PETFINDER
SOCIAL MEDIA (FACEBOOK)
PETCO
PETSMART
FRIEND/FAMILY
OTHER
*YOUR FIRST/LAST NAME
*ADDRESS
*CITY
*STATE
*ZIP CODE
*COUNTY LIVING IN
*PHONE NUMBER
*EMAIL ADDRESS
*ARE YOU EMPLOYED?
Choose a ARE YOU EMPLOYED?
YES
NO
STUDENT
RETIRED
OTHER
*TYPE OF RESIDENCE?
Choose a TYPE OF RESIDENCE?
HOUSE
CONDO
APARTMENT
MOBILE HOME
OTHER
*DO YOU OWN/RENT
Choose a DO YOU OWN/RENT
OWN
RENT
*RENTERS: DOES YOUR LANDLORD ALLOW PETS?
Choose a RENTERS DOES YOUR LANDLORD ALLOW PETS?
YES
NO
NA
LANDLORDS NAME
LANDLORDS PHONE
*DO YOU PLAN TO MOVE IN THE NEAR FUTURE?
Choose a DO YOU PLAN TO MOVE IN THE NEAR FUTURE?
YES
NO
*REASON FOR ADOPTION
*NUMBER OF ADULTS IN HOUSEHOLD?
*NUMBER OF CHILDREN IN HOUSEHOLD
AGES OF CHILDREN
*DO YOU HAVE PETS NOW?
Choose a DO YOU HAVE PETS NOW?
YES
NO
HOW MANY PETS DO YOU HAVE?
*HOW MANY CATS?
*HOW MANY DOGS?
*HOW MANY SPAYED/NEUTERED?
*CURRENT ON SHOTS
Choose a CURRENT ON SHOTS
YES
NO
OTHER ANIMALS? PLEASE EXPLAIN.
*WHAT PETS HAVE YOU HAD IN THE PAST
Choose a WHAT PETS HAVE YOU HAD IN THE PAST
DOG
CAT
OTHER
NA
WHAT HAPPENED TO YOUR LAST PET/EXPLAIN
HAVE YOU EVER LOST A PET TO:
'36' '99'
Choose a HAVE YOU EVER LOST A PET TO
POISONING
HIT BY CAR
DISEASE
STRAYED
STOLEN
OLD AGE
EXPLAIN LOSS OF PET
*HAVE YOU EVER HAD TO GIVE UP PET?
Choose a HAVE YOU EVER HAD TO GIVE UP PET?
YES
NO
NA
IF PET GIVEN UP/WHY?
*WILL YOU KEEP YOUR PET IF YOU MOVE?
Choose a WILL YOU KEEP YOUR PET IF YOU MOVE?
YES
NO
*ARE YOU PREPARED FOR THE COST OF NEW PET
Choose a ARE YOU PREPARED FOR THE COST OF NEW PET
YES
NO
*IS ANYONE ALLERGIC TO CATS IN YOUR HOME?
Choose a IS ANYONE ALLERGIC TO DOGS IN YOUR HOME?
YES
NO
*WHO IS YOUR PRESENT VET?
PRESENT VETS PHONE NUMBER
*WHERE WILL CAT LIVE?
Choose a WHERE WILL DOG LIVE?
INSIDE
OUTSIDE
IF OUTSIDE HOW WILL IT BE CONFINED?
WHAT KIND OF SHELTER DO YOU HAVE?
PLEASE NOTE: Whether your cat will live inside or outside, P.E.T.S. strongly opposes de-clawing cats. De-clawing a cat is the equivalent of cutting off a human’s finger at the first knuckle. Many countries, including the United Kingdom and Australia, have banned this surgery and deem it as animal cruelty.
*WILL YOU AGREE NOT TO DECLAW CAT?
Choose a WILL YOU AGREE NOT TO DECLAW CAT?
YES
NO
Do you feel willing and able to work with your cat and correct problem behavior if it should develop, like refusal to use the litter box, destructive clawing, jumping on cupboards and tables, digging in/eating plants. PLEASE ANSWER BELOW.
*BEHAVIOR PROBLEMS
Choose a BEHAVIOR PROBLEMS
YES
NO
What are your ideas for dealing with such behavior? Please note that not all behavioral problems can be corrected, as some of these cats came from very difficult situations, however with patience, perseverance, and kindness, most can overcome the problems. PLEASE EXPLAIN BELOW.
*EXPLAIN IDEAS FROM ABOVE
*WHO WILL BE RESPONSIBLE FOR NEW CAT
*HOW MANY HOURS A DAY WILL YOUR CAT BE ALONE?
*WHERE WILL YOUR CAT BE KEPT WHEN LEFT ALONE?
YOUR CAT WILL BE MICROCHIPPED FOR PERMANENT IDENTIFICATION. DO YOU AGREE TO REGISTER THIS MICROCHIP WITHIN 10 DAYS OF ADOPTION? PLEASE ANSWER BELOW.
*AGREE TO CHIP?
Choose a AGREE TO CHIP AND TAGS?
YES
NO
NOTE: If your cat will be wearing a collar, please be sure to use a safe-cat type collar that will either easily break off or expand to slip over the head should your cat become caught on something.
BOTH P.E.T.S ADOPTION POLICY AND IOWA LAW REQUIRE THAT ANIMALS ADOPTED FROM POUNDS AND SHELTERS BE ALTERED (SPAYED/NEUTERED).
*DO YOU AGREE WITH THE ABOVE STATEMENT?
Choose a DO YOU AGREE WITH THE ABOVE STATEMENT?
YES
NO
ARE YOU PREPARED TO GIVE YOUR CAT PLENTY OF TIME TO ADJUST TO ITS NEW HOME? WE ENCOURAGE THE 2 DAY, 2 WEEK TIME FRAME. IT WILL TAKE YOUR DOG APPROXIMATELY 2 DAYS TO BECOME FAMILIAR WITH THE NEW HOME AND 2 WEEKS TO BECOME COMFORTABLE WITH THE FAMILY AND OTHER PETS.
*WILL YOU GIVE THE CAT THE TIME NEEDED?
Choose a WILL YOU GIVE THE DOG THE TIME NEEDED?
YES
NO
*WOULD YOU CONSIDER ADOPTING 2 CATS?
I CERTIFY THAT THE INFORMATION I HAVE GIVEN IS TRUE AND AUTHORIZE INVESTIGATION OF ALL STATEMENTS MADE ABOVE
I UNDERSTAND THAT P.E.T.S HAS THE RIGHT TO REFUSE ANY REQUEST FOR ADOPTION.
*PLEASE SIGN FULL NAME HERE
*DATE
Save Form
Reset
Powered by
Elbowspace.com