Pre-Adoption Questionnaire: Cat
Please print and complete
this form, then turn it into one of our adoption counselors.
Remember, all questionnaires are subject to approval.
Pre-Adoption Questionnaire: Cat
Please print and complete
this form, then turn it into one of our adoption counselors.
Remember, all questionnaires are subject to approval.
Name _____________________________________________________________________________________
Address: _______________________________ City ____________________________Zip_________________
Telephone #: Day_________________________
Evening________________________
1. Do you live in: [ ] House [ ] Apartment [ ] Condo [ ] Other ______________
2. Do you: [ ] Own [ ] Rent [ ] Live with parents [ ] Live with roommate [ ] Military Housing [ ] Other _______________________
3. List your landlord’s name and phone # (if applicable)__________________________________
4. Why are you adopting a cat? [ ] as a family companion [ ] as a companion for another pet
[ ] as a personal companion [ ] as a mouser [ ] for my children [ ] other__________________
5. Are there any children in your household? [ ] Yes [ ] No If yes, what ages? _______________________
6. Have you ever owned a cat(s) before? [ ] Yes [ ] No If yes, how long ago? ________________________
7. How many pets are in your household? _____ Dogs_____ Cats_____Other________________
8. Are you planning to move in the near future? [ ] Yes [ ] No If yes, what will you do with your cat? ______________________________________________________________________________________
9. How many hours a day will your cat be left alone? [ ] 0-2 [ ] 2-4 [ ] 4-6 [ ] 6-8 [ ] 8-10 [ ] over 10
10. Where will your cat
stay during the day? [ ] indoors [ ] outdoors [ ] garage [ ] patio [ ] kennel
[ ] other__________________
11. Where will your cat stay at night? [ ] indoors [ ] outdoors [ ] garage [ ] patio [ ] kennel [ ] other ______________________
12. Do you currently have a veterinarian? [ ] Yes [ ] No If yes, what is the name of your veterinarian? ___________________________________________________________________
13. Have you ever had a cat declawed? [ ] Yes [ ] No Do you plan to declaw your cat? [ ] Yes [ ] No [ ] Undecided
15. How did you hear about
our adoption program? [ ] Petfinder.com [ ] EHS web site [ ] PETsMART [ ] newspaper
[ ] Other ___________________________________________