Cat Tail Kitties Screening Form

Adoption Information

Name Date

Address: City

State Zip Birth date

Home Phone Cell Phone Work

E-mail address ~

How long have you lived at the above address?

  1. How long have you been looking for a cat?
  2. Do you plan on moving?
  3. Do you own your own home? Rent?
  4. If renting, list landlord’s name and phone number.
  5. Do you live in a house? Condo Apt Mobil Home
  6. Are you currently employed? Occupation?
  7. Is the cat for you or someone else?
  8. The reason for the adoption? Family pet, child’s pet, companion for

other pet, gift, barn cat, other

  1. Does everyone know you are adopting or is it a surprise?
  2. Please list all residents in the house and the ages of children under 18

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  1. Is anyone in the home allergic to cats?
  2. Who will be mainly responsible for the cat?
  3. How many hours will the cat be left alone?
  4. Where will the cat stay during the day (specifically)
  5. Where will the cat stay at night (specifically)
  6. Will your cat be allowed on furniture/beds?
  7. Will you cat have the run of the house?
  8. How will you handle scratching or destructive behavior? ______

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(Over)

  1. Under what circumstances would your cat be kept outside or in the garage or

in the basement?

  1. What, in your opinion are the pros and cons or letting cats go outdoors?

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  1. Do you currently own any other animals? Yes No If so, please

list them and their ages and if they are spayed or neutered.

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  1. Please list any animals you have owned in the last 10 years.

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  1. Have you ever had an animal that you have given away? No Yes

If yes, please explain ______

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  1. Please list you current vet and their phone number. ______

______

  1. If this is your first pet, what veterinarian do you plan to use and their phone

number.

  1. Are you aware that vet care can cost you in excess of $300.00 per year?
  2. Are you willing to provide your cat with routine veterinarian care?
  3. What is your opinion on declawing? ______

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  1. Under what circumstances would you give your pet away? ______

______

  1. Are you willing to have a representative from Cat Tail Kitties check on the cat? ______
  2. Do you consider your cat to be a member of the family?
  3. Are you willing to give your cat quality time and attention?
  4. What type of food do you plan on feeding your cat?
  5. Would you consider leaving your cat outside unattended?
  6. Are you concerned about shedding?
  7. What would you do if your cat did not use the litter box? ______

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Approved by: ______Date: ______