Rescue Transfer Form – Cassie's Cats

Your Name *

First

Last

Rescue Organization *

Email *

Phone Number *

Cat's Name(s) *

You can use one form for multiple cats.

Age(s) *

Indicate if known or approximate

Gender(s) *

If more than one cat, indicate each name and gender.

Has/have the cat(s) been spayed/neutered? *

Yes
No
I don't know

Microchipped? *

Yes
No
I don't know

If microchipped, please provide the number(s).

How long have you had this cat? *

Where did this cat from? *

Does this cat(s) live around other cats or dogs? If so please describe how they get along. *

The more information we have the easier it will be to match them up with a good future adopter.

Please describe any known medical conditions and what is being done to treat them. *

Has this cat(s) been tested for FIV and/or FeLV? If so what were the results? *

This cat(s) is up to date on age-appropriate vaccinations. *

Yes
No
I don't know

Is there anything else we need to know about this cat(s)? Previous illness or injury? Behavior quirks? Food intolerances? Other? *

By signing below, I certify that the information provided is accurate and truthful to the best of my knowledge. I certify that I am the rightful owner/keeper/caretaker/custodian of the animal who is the subject of this Cat Surrender Form. I hereby surrender any and all property rights to the animal. I certify that no other person has a right of property to the animal. I understand that once I relinquish the animal, the animal will not be available to be returned. *

I agree

Full name *

This will serve as your electronic signature

Date *