ADOPTION APPLICATIONS
FELINE SURRENDER

Nobody knows your cat the way you do.

Thank you for filling out this form to help us care for your cat and match them with a new family. Operation Kindness does not euthanize animals for space or time. Behavioral and medical issues do not necessarily create problems, but failing to disclose them might. Your cat will undergo a behavior assessment and a brief health evaluation, while you wait. The health evaluation includes a $15 fee for a blood test. We will let you know before you leave if your cat is adoptable under current Operation Kindness policies. Completion and submittal of this form does not mean we have agreed to accept your pet.Please ask if you have questions.

YOUR CAT’S HISTORY
Cat’s Name:
Cat’s Nickname(s):
Tell us what you like best about your cat:
Why are you surrendering your pet today?
If we could help you resolve the issues surrounding the surrender of your pet, would you be interested in keeping your animal?
If yes, please stop here and speak with a member of our Intake staff: 972 | 418-7297

Age or approximate age:
How old was this cat when you acquired him/her?
What is your cat's current weight?
Is this cat a:
Male
Female
Unsure
Has this cat been spayed or neutered?
Yes
No
Unsure
Has this cat been microchipped?
Yes
No
Unsure
Has this cat been declawed?
Yes
No
If yes, where?
Front
Back
Front/Back
How long have you owned this cat?
Including your home, how many homes has this cat had?
Where did you acquire this cat?
Operation Kindness
Another shelter
Found as a stray
Friend/Relative
Pet store
Breeder
Free-to-good-home ad
Born in my home
Other

MEDICAL HISTORY
Did this pet receive regular exams by a veterinarian?
Yes
No
Unsure
Does this animal have any medical conditions or previous
injuries that require special attention or a special diet?
Yes
No
Unsure
Explain:
How does this cat behave at the vet’s office?
Calm, relaxed
Anxious, but calms down
Anxious, hisses and swats
Anxious, tries to hide or escape
Has never been to the vet
Very stressed, must be wrapped in towel or cat bag to examine
Must be sedated to examine
Please check all conditions that your cat has been diagnosed with or has been treated for and when:

Allergies
Urinary Tract Infection
Skin Problems

Old injury
Epilepsy/Seizures
Thyroid Disease

Heartworms
Kidney Disease
Ringworm

Diabetes
Hip dysplasia
Liver Disease

Heart murmur
Arthritis
Obesity

Upper Respiratory Infection

Other:

BEHAVIOR PROFILE
Check all traits that best describe your cat’s behavior:

Very energetic
Moderately energetic
Has one favorite person

Independent (a loner)
Friendly with everyone
Loves attention from people

Fearful
Reactive to strangers
Lap cat

Talkative
Lazy, Couch Potato
Affectionate

Friendly/affectionate to family members but shy with strangers

Other:
How active is your cat at night?
Quiet and sleeps
Very active and playful
Demands attention
Active, but entertains themselves
How does this cat like to be petted:
Where does this cat dislike being petted:
Does this cat jump on counters/table?
Yes
No
If yes, how do you manage it?
Does this cat mind being picked up?
Yes
No
If yes, is it all the time, or only specific situations, (i.e.: ok with being picked up as long as it was their idea)?
What ages/types of people lived with this cat?

Adult Men
Adult Women
Seniors

Children

0-2 years old

2-5 years old

6-10 years old

11-18 years
How does this cat behave around children? (check all that apply)

Actively avoided children
Cat hissed or growled at children

Cat swatted at children
Child could pet cat

Cat and child played together
Ignored each other

Other:
How does this cat behave around adults? (check all that apply)

Friendly/affectionate with all adults
Friendly/affectionate only with adults in family

Shy around strangers
Fearful around strangers; would go and hide

Other:
How does this cat behave around dogs? (check all that apply)

Never been around dogs
Friendly, no fighting
Cat rubbed on dog

Didn’t really care, ignored dogs
Cat picked on dogs
Slept near each other

Peacefully coexisted
Cat runs/hides from dog

Dog wouldn’t leave cat alone
Did not get along at all, constantly fought
How does this cat behave around cats? (check all that apply)

Never been around other cats
Friendly, no fighting
Adored each other

Groomed each other
Slept near each other
Very stressed

Peacefully coexisted, but not close

Didn’t really care, ignored one another

Didn’t get along, constantly fought
Does this cat have any of the following behaviors you consider a problem? (check all that apply)

Too vocal
Hides most of the time
Bites and scratches

Chews up plants
Fearful
Claws furniture/curtains/carpet

Soils outside litterbox
Insecure, too needy
Under foot constantly

Frequently throws up hairballs
Sprays/marks with urine inside the house

Knocks items off counters, shelves, tables

Unpredictable, sometimes becomes aggressive for no reason

Active at night or early morning when family is sleeping

Other:
LIFESTYLE & HOME LIFE
Was this cat: (check all that apply)

Indoors
Outdoors during the day, in at night
Outside 24 hours a day

In and out throughout the day
Is this cat litterbox trained?
Yes, completely
No, has frequent accidents
Mostly, has occasional accidents
If your cat has accidents:
Pee only
Poop only
Both pee and poop
How frequently? :
Daily
Weekly
Once in awhile
How long has this been occurring:
Had something changed in the household when accidents started occurring (i.e.: moved, new baby, new pet):
What type of litterbox did you use:
Covered
Uncovered
What type of litter did you use:
Clumping
Clay
Where was the litterbox located in your home?
How often did you clean the litterbox?
Daily
Every few days
Weekly
Other
Have you had any problems keeping this cat inside? (check all that apply)
No
Yes, occasionally darts out the door
Yes, tries to get out the door all the time
How does your cat like to play? (check all that apply)
Likes to play rough, may bite or scratch
Likes to chase and pounce with toys

Likes things that crackle, like a paper bag
Likes to play hide and seek

Will fetch items like a bottle cap or toy
Plays gently does not usually use teeth or claws

Likes to climb on things
Likes to play in or around water

Likes to play with other cats
Does not show interest in play

Sometimes watches or bats at a toy if we entice, but doesn’t go out of way to play
Are there any special habits you have with your cat? (check all that apply)
Give a treat before bedtime
Give a toy or treat when leaving the house

Give cat nip occasionally/often
Give a toy or treat when leaving the house

Has an area to look out the window

Other
Has this cat ever been aggressive towards people or animals? (check all that apply)
Yes, has attacked or bitten people
Yes, has attacked or bitten other cats

Yes has attacked or bitten other animals (what kind of animal?):

No, has shown no aggression towards animals or people

DIETARY HABITS
What brand of food did this cat eat?
Premium brand (Wellness, Science Diet, etc.)
Grocery store brand (Purina. Special Kitty)

Generic brand
Home cooked diet

Prescription Diet – which one?
Other
Which of the following does your cat eat?
Dry food only
Canned food only
Combination of dry and canned

Table scraps
Home cooked diet
Other

Do you feed your cat treats?
no
yes
What Kind?
How often was this cat fed?
Once daily
Twice daily
Food always available
Other
Please feel free to add additional comments below that you think would be helpful to shelter staff or potential adopters.
Upload a current photo of your cat: adopters.

Signature
Date
Phone Number
Email Address
By signing this I'm confirming my animal has not bitten anyone in the past 10 days.
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Thank you for providing us with these details about your animal
and for trusting us with their care!