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Cat Assist Team Whitchurch
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Pre Adoption Questionnaire
Contact Details
First name
*
Last name
*
Date of Birth
*
Day
Month
Year
Address
*
Town/City
*
Post Code
*
Email
*
Phone
*
Household Details
Are you interested in:
Cat
Kitten
Either
Would you consider a bonded pair?
Yes
No
Name of cat(s) of interest if applicable.
Who are you adopting this pet for?
*
Myself
Family
My Child
Other
Who will be the primary caregiver?
*
Myself
My Partner
My Child
Other
If other has been selected please give further details.
Are you looking for an indoor only or free access/outside cat?
*
What type of home do you live in?
*
Detatched
Maisonette
Semi Detatched
Flat
Bungalow
Other
Do you have a back garden
*
Yes
No
Communal
What is behind your garden?
Is your home situated by any fast moving traffic?
*
Yes
No
Other
If other has been selected please provide further detail.
Do you currently:
*
Own
Council Rent
Private Rent
Housing Association
How long have you lived at your current address?
*
How many adults live in the home?
*
How many children live in the home?
*
Please list ages of all children in the home. Please put N/A if not applicable.
*
Do you have the property owners permission to to have pets?
*
Does anyone in the home have any pet allergies?
*
If yes has been selected please provide further detail.
Are you planning on moving home within the next 6 months?
*
Yes
No
Other
If other has been selected please provide further detail.
If you had to move what would happen to your pets, could you guarantee they would move with you?
*
Where will your pet stay during the day?
*
Indoors
Outside
Indoor enclosure
Other
Free access / Cat flap
Where will your cat stay overnight?
*
Indoors
Outside
Indoor enclosure
Other
Free access / Cat flap
If other has been selected please provide further detail.
How many hours in a 24hr period will your cat be alone?
*
0
1 - 3
3 - 6
6 - 9
9 - 12
12+
How many hours in a 24hr period will your cat be with you?
*
0
1 - 3
3 - 6
6 - 9
9 - 12
12+
Brief description of working schedule. Please put N/A if not applicable.
*
Other Pets Details
Do you already have pets in your home?
*
Are your pets spayed / neutered?
*
Are your pets up to date on vaccinations?
*
Please tell us what pets you have already and a little about them.
Would you be happy to have the above information about your pets neuter and vaccinations, confirmed by your vet in writing if deemed necessary.
*
Other
Would you be open to adopting a cat with behavioural or medical needs?
*
Yes
No
Unsure
Are you prepared for the cost of owning a cat?
*
Yes
No
Would you consider taking out pet insurance for your cat?
*
Yes
No
Do you agree to C.A.T.W keeping your details on file and to be contacted, should a cat or kitten fitting your family and preferences becomes available?
*
Yes
No
Signature and Date
By completing this form, I confirm that all details provided are true and correct to the best of my knowledge.
*
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Date
*
Day
Month
Year
Submit
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