Whisker City CAT RELINQUISHMENT FORM

CAT RELINQUISHMENT FORM

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The following information will help us find the best possible home for the cat. Please fill in the information as completely and accurately as possible. Thank you.

Cat's Name:
Breed:
Color/Markings:
Age:
Sex:
Spayed/Nueterd:

How did you aquire this cat?

How long has this cat lived with you?
How many owners has this cat had?

Why are you giving up this cat?

HEALTH
(Please provide veterinarian records, if possible.)

Name of Vet/Clinic
Vet’s Phone:
Date of last shots

Past or present injuries or medical conditions:
Current medications:

DIET
Does this cat require a special diet?
If YES, describe:

What does this cat eat? Brand or type?

Dry food
Wet food
Treats
Table scraps

How often is this cat fed?

SCRATCHING BEHAVIOR
Is this cat declawed?
If YES, why?

Does this cat use a scratching post?
If YES, what type?..........

Does this cat claw?
Furniture or Upholstery?
Carpets or rugs?
Drapes?

Other:

LITTERBOX BEHAVIOR
Does this cat use a litterbox?

If YES, where is it kept?
Type of litter:

Does this cat have “accidents”?
If YES, how often?

Are physical problems ruled out?
Are there situations which cause this cat not to use
the litterbox? YOUR HOUSEHOLD
Your household is best described as…
This cat is:

This cat prefers…
Has this cat lived with children?
Children’s ages:
Describe the relationship:
Has this cat lived with other pets?
Types of pets:

Describe the relationship:

PERSONALITY & BEHAVIOR
This cat is…


Friendly............		Outgoing......
Relaxed............		Playful...........
Hyperactive......		Vocal............
Independent.....		Timid/Shy.....
Aloof...............		Lazy..............

Slow to adjust to new situations
Other:

This cat.…
Likes to be held or carried......................
Likes to sit on laps .................................
Likes to be brushed or groomed..............
Likes to sleep on the bed........................
Likes to ride in the car .............................
Likes catnip ............................................
Likes to hunt ...........................................
Climbs on counters .................................
Lets the owner clipits’ nails ....................
Gets hairballs .........................................
Gets mats?...............................................
Does this cat have a favorite toy? ...........

If YES, describe:
Is this cat frightened of anything?
If YES, describe:
Has this cat scratched or bitten anyone?
If YES, describe:
Are there other bad habits a new owner should be
aware of?
If YES, describe:
What form of discipline have you used with this cat?
Has it worked well?

Is there anything else we should know about this cat?

Please provide any additional history or information that will help us place this cat in the best possible home.

How did you hear about Whisker City?

If it was a store told you about us can we have the name?

Please provide the following information so that we can contact you with additional questions.
We will not share this information with anyone.

Your Name:
Email:
Phone:
Best time to call: AM / PM

Provide mailing address if you would like to be included on our newsletter mailing list:

Address:
City, State, Zip:

I would like to make the following donation to Whisker City:

Donate by phone:
Call 206-542-0947

Donate by mail:
Whisker City, PO Box 77214,
Seattle, Washington 98133
(Make check payable to Whisker City)

For more information call:
April Brown at 206-542-0947

WHISKER CITY is a 501-c3 cat rescue organization.

I hearby transfer ownership of this cat to Whisker City.
Please allow my vet records to be released to this orginzation.
By entering my name and date in the area below,
I am certify that the information I have given is true.

Name: Date:

We appreciate your thoroughness in filling out this form.

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