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Animal-Friendly Housing
Selecting a Breeder
Spay/Neuter Assistance Program
Surrender an Animal
Cat Profile
* Required fields
*First name:
*Last name:
*E-mail:
*Address line 1:
Address line 2:
*City:
*State:
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South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*Zip:
*Phone:
Cat's Name:
Breed or Markings:
Color:
Age:
Sex:
Female
Male
Spayed or Neutered:
Unknown
Yes
No
Declawed:
Not Declawed
Front Paws Only
All Four Paws
If declawed, at what age?
Where did you get your cat?
Breeder
Pet Shop
Humane Society
Friend
Other
If other, please specify:
Is your cat:
An indoor only cat
An outside only cat
Allowed indoors & outdoors
Why are you surrendering your cat to the Humane Society? (Be specific)
How long have you owned your cat?
What are two things you like the most about your cat's behavior?
Have there been recent changes in the home? Example: moving, new pet, new baby
Has your cat ever bitten anyone?
Yes
No
Did the bite break the skin?
Yes
No
How many times has your cat bitten?
Explain the circumstances:
Does your cat use his or her litterbox?
Always
Sometimes
Never
Does your cat:
Poop outside the box
Pee outside the box
Pee and poop outside the box
If sometimes, how often does your cat make mistakes?
What surfaces and places does your cat choose to use instead of the litterbox?
How many litterboxes can your cat access?
How often is the litterbox(es) scooped out?
How often are the litterboxes completely emptied and washed?
What kind of litterbox does your cat use?
Open
Hooded
Other
If other, please describe:
What kind of litter do you provide for your cat?
Sand-like clumping litter
Clay
Other
If other, please describe:
Is the litter:
Scented
Unscented
Don't know
Where are the litterboxes located? (If you live in a multi-level home or apartment please indicate on which floor the boxes were kept, as well as location.)
Does your cat: (Check all that apply)
Scratch furniture
Scratch on doors or cabinets
Chew plants
Chew personal items (clothing, shoes, etc)
Does your cat use a scratching post?
Yes
No
What type of post does he/she use?
How affectionate is your cat?
1 - Not at all
2
3
4 - Somewhat
5
6
7 - Very
Does your cat like to be picked up?
1 - Not at all
2
3
4 - Somewhat
5
6
7 - Always
Does he/she struggle to get down when picked up?
Yes
No
When you sit down does your cat jump onto your lap?
1 - Never
2
3
4 - Sometimes
5
6
7 - Always
Does your cat tell you to stop petting him/her?
Yes
No
If yes, how does he/she tell you to stop?
Does your cat prefer to play:
Roughly
Gently
Unknown
What is his/hers favorite toy(s)?
When playing does your cat nibble on hands?
1 - Never
2
3
4 - Sometimes
5
6
7 - Always
Does your cat ever play by pouncing on your feet?
1 - Never
2
3
4 - Sometimes
5
6
7 - Always
Does your cat live with other cats?
Yes
No
If yes, how many, what age and what sex?
Does your cat:
Spend time and/or play with the cat(s)
Actively fight with the cat(s)
Avoid the cat(s)
Does your cat live with dogs?
Yes
No
If yes, how many?
Does your cat:
Spend time and/or play with the dog(s)
Actively fight with the dog(s)
Avoid the dog(s)
Number of children in the home:
Ages:
Does your cat:
Spend time and/or play with children
Hide from children
Avoid children
When guests come over does your cat:
Solicit petting and attention from guests
Run and hide from guests
Run and hide but come out later to meet guests
How comfortable is your cat with brushing?
1 - Not at all
2
3
4 - Somewhat
5
6
7 - Very
Unknown
How comfortable is your cat with clipping nails?
1 - Not at all
2
3
4 - Somewhat
5
6
7 - Very
Unknown
Does your cat have any medical problems or require medication?
Yes
No
Don't Know
If yes, please explain:
Is your cat current on all vaccinations?
Yes
No
Has your cat been tested for Feline Leukemia?
Yes
No
How does your cat react when being seen by a veterinarian?
What, if any, behavioral problems does the cat have?
2073 Highway W, Grafton, WI 53024
(262) 377-7580
info@ozaukeehumane.org
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