Home Surrender Form – Cats

Surrender Form – Cats

"*" indicates required fields

Your Information

Full Name*

Address*

City/Town/RM*

Province*

Postal Code*

Phone Number*

Email Address*

Why are you surrendering your cat/kitten?*

How will you be paying the surrender fee?*

If other, put details here:

Donation amount, type of food and/or supplies

Cat Information

Cat's Name*

Cat's Age (approximately)*

Breed

Colouring*

Gender*

Male

Female

Unsure

Spayed/Neutered*

Yes

Unsure

Vaccinated*

Yes

Unsure

Tattooed/Microchipped*

Yes

Unsure

Where did you get the cat/kitten?*

How long have you had it?*

How many homes (including yours) has the cat had?*

Behaviour

How does the cat behave with adults (choose all that apply)?*

Playful

Hides

Scratches/hisses

Aggressive

Unknown

Please explain in more detail:

How does the cat behave with children (choose all that apply)?*

Playful

Hides

Scratches/hisses

Aggressive

Unknown

Please explain in more detail:

How does the cat behave with visitors and strangers (choose all that apply)?*

Playful

Hides

Scratches/hisses

Aggressive

Unknown

Please explain in more detail:

How does the cat behave around dogs (choose all that apply)?*

Aggressive

Scared

Ignores

Playful

Scratches/hisses

Unknown

Please explain in more detail:

How does the cat behave around other cats (choose all that apply)?*

Aggressive

Scared

Ignores

Playful

Scratches/hisses

Unknown

Please explain in more detail:

Has the cat ever bit, scratched, or become rough during play (with a person, dog, or other cat)?*

Yes

Please explain in more detail:

Has the cat ever been in a serious fight with another animal?*

Yes

Please explain in more detail:

How many people live in the home with the cat?*

Include number of ALL adults and children

How many children (age 16 or under) live in the home with the cat?*

Only AGES of children required

Did the cat get along with everyone living in the home?*

Yes

Please explain in more detail:

Is the cat litter box trained:*

Fully litter box trained

Rare accidents (less than 1 time per month)

A few accidents a month

A few accidents a week

Not litter box trained

If the cat eliminates outside the box, is it urine, feces, or both?

Does the cat display destructive behaviour?*

Yes

Please explain in more detail (what type of behaviour, when does it occur, etc):

Where does the cat sleep at night?*

Indoors

Outdoors

Other

Where does the cat spend most of its day?*

Indoors

Outdoors

Other

Please describe in more detail:

Please describe the cat's accomodations when outside.

How long is the cat left alone on an average day?*

Handling Tolerance (choose all that apply):*

Allows being pet

Allows being groomed (brushed/bathed)

Allows being picked up

Allows being played with

None of the above

Does the cat use a scratching post?*

Yes

Sometimes

Unknown

How would you describe the cat's personality?*

What do you like best about the cat?*

What are some of the cat's favourite things?*

How well does the cat travel in a vehicle (short and long distances)?*

What is the cat afraid of and how do they react? Please describe in detail.*

What poor habits does the cat have and what have you done to try and curb the negative behaviour? Please describe in detail.*

Health

When was the last time the cat was seen by a veterinarian?*

How often does the cat visit the veterinarian?*

How does the cat behave during vet visits?*

Does the cat have any allergies?*

Yes

Unknown

Please describe in more detail:

Is the cat on any medications?*

Yes

Please describe in more detail:

Has the cat had any health problems in the past?*

Yes

Unknown

Please describe in more detail:

Does the cat currently have any health problems?*

Yes

Please describe in more detail:

Additional Information

Is there any additional information you would like us to know about the cat?

Last modified: August 3, 2024

What the Floof?

Shelter News 1
What the Floof? 44
- Activities 6
  - For Kids 4
  - For Parents 4
  - For Teens 1
- All About Cats 29
- All About Dogs 38

The Pembina Valley Humane Society is a volunteer-run, non-profit organization serving the communities within the Pembina Valley and beyond.

Charitable # 852072370RR001

Shelter Hours

Mon: Closed
Tue: 12PM-6PM
Wed: 12PM-7PM
Thurs: 12PM-7PM
Fri: 12PM-5PM
Sat: 12PM-5PM
Sun: Closed

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(204) 822-9413
hello@pvhsociety.ca

462 Jefferson Street
Morden, MB R6M 1Y4

The PVHS is located on the original lands of the Anishinaabeg, Cree, Oji-Cree, Dakota and Dene peoples, and on the homeland of the Métis Nation. We respect the Treaties that were made on these territories, we acknowledge the harms and mistakes of the past, and we dedicate ourselves to moving forward in partnership with Indigenous communities in a spirit of reconciliation and collaboration.

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