DVSCFA, INC Adoption Screening E-Form for Cats

Name:
Street Address:
City:
State Zip Code
Your E-Mail Address:
Home Phone:
Cell Phone:
Employer:
Work Phone:
Occupation:
Name of cat you are interested in:
Do you live in:
Do you own or rent your home?:
Name and phone number of Landlord or
housing complex to confirm they allow cats:
(A website is also acceptable):
Number of Adults in House:
Number of Children in House:
What kind of pets do you currently have [if any]
(dogs, cats, birds, snakes, gerbils)?:
What are the breeds and ages of these pets?:
Are all your cats/dogs spayed or neutered?:
If you answered mixed spay/neuter, please explain:
Do any of your cats go outside?:
Do you plan on getting your adopted cat declawed?:
Is anyone in your house allergic to cats?
Which family member will have the major
responsibility of caring for your pet?:
Average number of hours a day someone is home:
Where will your pet spend a majority of it's time?:
How many times have you moved in the past 5 years?:
Do you plan to move anytime soon?:
What type of pets have you previously owned?:
What happened to them?:
Has a pet ever gotten lost/run away?:
If yes, please explain:
Have your cats or dogs ever been hit by a car?:
Name and phone number of current
or most recent veterinarian:
Would this be your first pet?:


We recommend that you provide two references that we can contact
Reference 1 Name:
Reference 1 Number:
Reference 1 Email:
Relation to Reference 1:
Best time to call Reference 1:
Reference 2 Name:
Reference 2 Number:
Reference 2 Email:
Relation to Reference 2:
Best time to call Reference 2:

Since most animals have unknown medical backgrounds, are you prepared to take your new cat for a complete veterinary exam within 10 days of adoption, and to provide any necessary medical treatment at your own expense?
Do you agree to return your adopted cat to the DVSCFA Cat Volunteers if for any reason you are unable to keep it?

Comments, Questions, Suggestions


Please review this form before you click on Send!  Once you have done that your form, with all its information, will have been emailed.

The purpose of this application is to place the pet in what we feel is the best suitable home. We reserve the right to refuse any adoption. You should hear from a DVSCFA Cat Volunteer within 24 Hours.