Adoption Form

Primary Phone Number

Secondary Phone Number

What type of cat are you interested in?

Is there is a specific cat from our website you are interested in? If yes, please provide his/her name here

How many people currently reside in your household?

Are there any children in your household?

Yes No

If yes, list their ages

For whom are you adopting the cat?

For yourself As a gift for someone else

Does any member of your family have allergies to animals?

Yes No

If yes, please explain

Who will be responsible for the cats care?

Where do you live?

Do you own your own residence?

Own Rent

If you rent, what is your landlord's name?

If you rent, what is your landlord's phone number?

Are pets allowed where you live?

Yes No Not sure

Do you agree to keep the cat indoors?

Yes No Both in and out

If outdoors, the cat will be:

on leash or in catio Unattended Collared and tagged

Will anyone be home during the day?

Yes No

How many hours will the cat be left unattended?

When no one is home, where will the cat be kept?

If you move, what will you do with the cat?

Have you ever had a pet before?

Yes No

Describe the pets you still care for or that are living in your household

Are your pets neutered

Yes No

Where are your pets kept?

Describe the pets you no longer care for

Were your pets neutered

Yes No

Where were your pets kept?

Reason they are no longer with you

Are your pets current on their vaccinations?

Yes No

Name of your veterinarian

Phone number of your veterinarian

Are you financially able and willing to provide annual check ups, vaccinations and ANY medical care necessary?

Yes No

Do you have a dog?

Yes No

If yes, are they permitted to run loose?

Yes No

What precautions would you take to properly introduce a new cat into your home if you have other animals (a dog, bird, rabbit, another cat, etc.)?

What will you do if your new cat does not get along with your present pets?

Do you plan to declaw (surgically remove) your cats claws?*

Yes No

Have you ever had an application rejected for adoption of an animal from a rescue/animal control facility?

Yes No

If yes, please explain

Why do you want to adopt a cat?

If a disciplinary or behaviour problem arises, what steps will you take to work on it?

Are you familiar with your local animal control laws?

Yes No

Are you willing to sign legal pet adoption papers?

Yes No

Do you agree to permit a visit to your home/farm by appointment?

Yes No

Are you able to bring your kitten/cat to our vet for scheduled appointments?

Yes I am able to do so No I am not able to do so

Please list two references not living with you, including phone numbers below:

Do you understand that our adoption fees are $300.00 (unless otherwise posted) which cover the FELV and FIV virus testing, vaccinations, booster shots, rabies shots, and spay / neuter surgery?

I understand and agree to this fee

Declaration

Applications must be approved (applying does not guarantee approval). Approval is based on the best interest of the animal(s). Caring Hearts Cat Rescue reserves the right to refuse any application we think is not in the animal’s best interest. Due to time constraints, not all applications will be acknowledged by the rescue. By clicking this box, I/we acknowledge that all information on this form is true and correct. I/we understand that any misrepresentation of fact may result in Caring Heart Cat Rescue & Sanctuary refusing adoption privileges to me/us. If my/our request for adoption is approved and later Caring Hearts Cat Rescue & Sanctuary discovers the above information is not true or correct, Caring Hearts Cat Rescue & Sanctuary reserves the right to remove the adopted cat from my home/farm. By clicking this box, I/we acknowledge that all information on this form is true and correct. I/we understand that any misrepresentation of fact may result in Caring Heart Cat Rescue & Sanctuary refusing adoption privileges to me/us. If my/our request for adoption is approved and later Caring Hearts Cat Rescue & Sanctuary discovers the above information is not true or correct, Caring Hearts Cat Rescue & Sanctuary reserves the right to remove the adopted cat from my home/farm.

Full Name for Declaration

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