First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone*

What is your cat or kitten's Name?*

Was your cat adopted from North Texas Cat Rescue?*

DOB (You must be 21 to foster)*

If yes, please tell us the name of your cat when it was adopted and the name of the person that signed the adoption paperwork.*

Is your cat*
Choose one: Male Female

Is your cat Spayed or Neutered?

If your cat/kitten is microchipped please enter the name of manufacturer + number. By adding the chip # you agree to authorize North Texas Cat Rescue to transfer ownership of the microchip of the cat described on this form to them. *

Your cat's current weight:*

Why do you need to surrender your pet(s)?*

If we could help you resolve the issues that you are having with your cat, would you be interested in keeping your cat? *
Choose one: yes No Maybe

In the past 7 days, has your cat bitten or scratched a person and broken the skin? If yes explain here the circumstances.*

Is your cat declawed? if yes please indicate date it was done and name of Veterinarian who performed the surgery*

Is your current on vaccinations?

Have you had any problems keeping your cats inside?

Where is your cat kept? During the day and at night?*

Is your cat litterbox trained?

What brand?
Choose all that apply: OTC brand dry name prescription food wet

In the past year, has your cat been diagnosed or treated for any of these conditions (check all that apply)

Does your cat like being handled or petted?
Choose all that apply: No Unsure Yes

Has your cat been around children?
Choose all that apply: Children 6-12 years old Children under 6 years old Teenagers toddler

How does your cat behave around children?
Choose all that apply: aggressive gentle has little patience scared

How does your cat behave around other cat(s)?
Choose all that apply: gets along with other cats doesn't get along with other cats gets along with female cats gets along with male cats I don't know

Has your cat ever been aggressive towards other cats?

Has your cat ever been aggressive towards other animals?

Has your cat ever been aggressive towards people?

How does your cat like to play? *
Choose all that apply: Likes to play rough, may bite or scratch Likes to climb on things Likes to play with other cats Likes to chase and pounce toys Doesn’t like to play

Does your cat have any of the following behaviors? (check all that apply)
Choose all that apply: Bites and scratches Claws furniture/curtains/carpet Fearful Frequently throws up hairballs Problems using litterbox Unpredictable, sometimes aggressive for no reason None

Does your cat have any other behaviors or quirks that you are not fond of? Please describe in detail.*

Is there any other information that you think might be helpful for us to know? *