It is my policy to make certain that each person who adopts an animal is aware of the responsibilities of having a pet and is capable of and willing to accept those responsibilities morally, physically and financially. By completing this questionnaire, you will aid me in determining if the animal of interest would suit you and your lifestyle. Adoptions are made by appointment only. We do charge an adoption fee.
Information about yourself:
Name*
Name of Spouse, Partner, or Roommate
Street Address*
City*
State*
Zip*
Home Phone*
Work Phone
Cell Phone
Your Email*
How did you hear about us?
About the cat you are interested in adopting:
1. Which cat are you interested in adopting?
2. Why do you want to adopt this pet? (select all that apply)Companion for Another Pet Companion for Self Gift Barn Cat As a Mouser Replacement Pet To Breed
3. How long have you been actively looking for a new pet?
Select One Days Weeks Months Decided today
4. How will you care for your pets nails?
Select One Trim Regularly Keep Natural (Don't Trim) Apply Nail Caps Declaw N/A (Cat of interest is already declawed)
5. Where will your new pet live?
Select One Indoor Only Outdoor Only Indoor/Outdoor
6. How and where will the pet be expected to relieve him/herself?
Select One Inside (Litterbox) Outside Both
7. Who will be responsible for the pet's daily care? (select all that apply)
Self/Adult Self/Minor Spouse Parent/Guardian
8. Who will be financially responsible for the pet? (select all that apply)
Self/Adult Self/Minor Spouse Parent/Guardian
9. How much will you budget for care each month (includes supplies & health care)?
Select One $10-$20 $20-$25 $25-$40 $40+ Don't Know
About your current pet(s):
10. (a) Are there other pets in the household now?
Select One Yes No
(b) If you answered "Yes" to the previous question, please provide a detailed description about your pet(s), indicating type, sex, age, spayed/neutered, lived indoors/outdoors:
11. Do you vaccinate your pet(s)?
Select One Yearly Every Other Year Every Three Years Only During Kittenhood Never
12. (a) If there are no pets in the household now, have you owned any pets before?
Select One Yes No Currently have pets
(b) If you answered "Yes" to the previous question, where is the pet(s) now?
Select One Gave away Lost Deceased Never Owned
13. If any pets died in the last 12 months, what were the circumstances?
Select One Old Age Accident Illness Disease Unknown No deaths
Please explain:
Veterinary references:
14. Name and phone number of veterinary reference:*
15. Name and phone number of veterinary to be used for new pet if different from above:
Information about your household:
16. Type of residence:
Select One House Duplex Apartment Condo Townhouse Mobile Home Rooming House Dorm
17. Length of time living at this address:
Select One Less than 1 year 1-3 years Over 3 years
18. (a) Do you own or rent the home you live in?
Select One Own Rent
(b) If renting, what are the pet regulations?
19. What age groups live in your household? (select all that apply)
Adults Seniors Adolescents Children Infants
Any additional information you would like us to know:
