Cat Surrender Profile
Cat’s Name: ______How long have you owned this cat? ______
Why are you surrendering your cat? ______
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Is your cat: 1 indoor only 1 indoor/outdoor 1 outdoor only
Personality & Behavior
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How would you describe your cat most of the time? (check all that apply)
1 Very active 1 Friendly to family 1 Friendly to visitors 1 A clown 1 Couch potato 1 Shy to family
1 Shy to visitors 1 Playful 1 Talkative
1 Affectionate 1 Independent 1 Aloof
1 Quiet 1 Lap cat 1 Withdrawn
1 Playful 1 Fearless 1 Fearful
1 Solitary 1 More like a dog 1 Other ______
Where does this cat dislike being petted?
Has this cat ever acted aggressively toward a person? 1Yes 1 No
If yes, please fully describe situation.
Play Style
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How does this cat like to play? (check all that apply)
1 Plays gently, does not use teeth or claws
1 Likes to play rough, may nip or scratch
1 Likes to chase & pounce with a variety of toys
1 Likes things that crackle, such as paper bags
1 Will fetch items like bottle caps or toys
1 Likes to play with other cats
1 Likes to play with dogs
1 Not much interest in play
1 Chases bugs or moths
1 Likes to play in or around water
Lifestyle & Home Life
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If this cat lived with other cats, how did they interact? (check all that apply)
1 Adored each other 1 Played together 1 Sniffed noses
1 Slept near each other 1 Peacefully coexisted 1 Ignored each other
1 Fought without injuries 1 Fought with injuries 1 Rough with others
1 Groomed each other 1 Caused this cat stress 1 Gentle with others
If this cat lived with dogs, how did they interact? (check all that apply)
1 Adored each other 1 Slept near each other 1 Avoided each other
1 Groomed each other 1 Cat rubbed on the dog 1 Played with each other
1 Peacefully coexisted 1 Ignored each other 1 Fought without injuries
1 Fought with injuries 1 Dog chased cat 1 Cat tormented dog
1 Cat feared dog 1 Sniffed noses 1 Caused this cat stress
Has this cat been regularly been around children? 1 Yes 1 No 1 Not sure
If yes, what ages: 1 0-2 yrs. 1 3-5 yrs. 1 6-10 yrs. 1 11-18 yrs.
What ages of children would you recommend for this cat?
1 0-2 yrs. 1 3-5 yrs. 1 6-10 yrs. 1 11-18 yrs. 1 No children under 18
If this cat lived with children under the age of 5, how did they interact? (check all that apply)
1 Cat actively avoided child 1 Child could pet the cat
1 Cat & child played together 1 Cat hissed or growled at child
1 Ignored each other 1 Mutual adoration
1 Other ______
Have the experiences with the cat and child(ren) always been positive? 1 Yes 1 No
If no, please explain. ______
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Does your cat do any of the following? (check all that apply)
1 Jumps on counter/tables 1 Scratch furniture 1 Chew plants
1 Scratch doors/cabinets 1 Chew personal items 1 Climb curtains
1Other ______
Litter Box Habits
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Did your cat have access to a litter box in the house? 1 Yes 1 No
If no, did your cat use the bathroom only outdoors? 1 Yes 1 No
If yes, did your cat use the litter box? 1 Yes 1 No 1 Sometimes
If sometimes, how often did your cat make mistakes? ______
Please describe the accidents:
1 Urinates outside the box 1 Urinates on clothing/furniture
1 Defecates outside the box 1 Sprays on wall/furniture
1 All of the above 1 Other ______
How often was the litter box scooped? 1 Every day 1 Every few days 1 Weekly 1 Rarely
What type(s) of litter was used? 1 Unscented 1 Scented 1 Clumping
1 Non-clumping 1 Crystal 1 Clay 1 Pine
1 Yesterday’s News 1 Other ______
How many cats in your household? ______
How many litter boxes did you have? ______
Please use the rest of the page to add any additional comments about your feline friend.
Thank you!
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