Cat Re-homing Form

First Name

Last Name

Street Number

Unit Number (if applicable)

Street Name

City

Postal Code

Email Address

Phone Number

Your Cat's Name

Pet's Age

Breed Breed Long Hair Short Hair Persian Himalayan Siamese Other

Colour

Sex Sex Male Female

Spayed or Neutered Spayed or Neutered Yes No

Declawed Declawed Yes No

Declawed Details Declawed Details Front Only All 4 Not Applicable

Microchipped Microchipped Yes No

Reason why you wish to surrender (please be as specific as possible)

Behaviour Issues

How long have you owned the cat?

Where did you get the cat?

Has the cat ever bitten anyone? Has the cat ever bitten anyone? Yes No

Does that cat use its litter box? Does that cat use its litter box? Yes No

If not, what steps have you taken so far to resolve the issue?

Name of your Vet Clinic

Last vet visit?

What type of food do you feed your cat?

When was the cat’s last vaccination?

Health Issues?

Number