Name (First & Last):
*Email Address:
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info@retrieversandfriends.com in your "ALLOWED" list.
Home Phone:
Work Phone:
Address:
City:
State: CA
Zip:
Number of people who reside in your home:
???
0
1
2
3
4
5
6
7
Ages of people who reside in your home:
Your Employer:
Spouse's Employer:
What is your work schedule?
???
Full Time
Part Time
Work from home
Not Employed
About Your Home
Do you live in a:
???
House
Apartment
Condo or Townhouse
Mobile Home
How long at this address?
Do you rent or own your home?
Landlord's Name (if applicable):
Landlord Phone:
Does your rental agreement allow you to have a pet?
Does anyone in your family have allergies?
???
No
Yes
If yes, please explain below:
What is your household activity level?
Quiet
Active
Very active
Do you have a local veterinarian?
Yes
No
If yes, please list name and phone number below:
May we call your veterinarian for more information?
???
Yes
No
Please tell us what you're looking for:
Name of cat(s) you are interested in (from web site):
How long have you been looking for a pet?
Just started
A month or more
Six months or more
What age of cat would you like to adopt?
Would you like to adopt a male or a female?
Breed:
Size:
Color:
Why are you interested in adopting this particular breed of cat?
How soon are you ready to adopt?
General Information
If this cat chews, scratches, or has any bad habits, what will you do?
Under what circumstances would you consider giving away your cat to a new
owner?
Who will be responsible for the care and feeding of this cat?
What brand of cat food you plan on feeding this cat?
What arrangements would you make for the this pet when you travel?
Kennel
Pet Sitter
Friends, family, or
neighbors will provide care
We will take our pet with us
We do not travel
Do you have any upcoming travel or vacation plans?
If yes, when will you be leaving and how long will you be gone?
Where will this cat be kept during the day while you are gone?
How many hours are you
usually gone during the day?
Where will the cat be
when you are home?
Where will the cat
sleep at night?
How do you
plan on training your new cat to use the litter box?
Your Pet History
Please provide the following information for any pets you now own or
have owned in during your adult life. You may add additional
pets in the "comments" section below.
Pet #1
Breed
Age
Sex
Is your pet spayed or
neutered?
Do you still have this
pet?
If this pet is no
longer with your family, please explain. (Cause of death, or
to whom the pet was given and why.)
Pet #2
Breed
Age
Sex
Is your pet spayed or
neutered?
Do you still have this
pet?
If this pet is no
longer with your family, please explain. (Cause of death, or
to whom the pet was given and why.)
Pet #3
Breed
Age
Sex
Is your pet spayed or
neutered?
Do you still have this
pet?
If this pet is no
longer with your family, please explain. (Cause of death, or
to whom the pet was given and why.)
Pet #4
Breed
Age
Sex
Is your pet spayed or
neutered?
Do you still have this
pet?
If this pet is no
longer with your family, please explain. (Cause of death, or
to whom the pet was given and why.)
Pet #5
Breed
Age
Sex
Is your pet spayed or
neutered?
Do you still have this
pet?
If this pet is no
longer with your family, please explain. (Cause of death, or
to whom the pet was given and why.)