Name
*
First Name
Last Name
Email Address
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Why are you surrendering your pet today?
*
Adopted Pet's Current Name
*
Adopted Pet's Nickname
I verify that this pet was adopted from Wright-Way Rescue.
*
This form is only applicable to Wright-Way Rescue adopters.
Please tell us why you are giving up this pet. Please be honest as this will help us understand why this pet is not working out in it's current home and how we can re-home the pet in a more appropriate home.
*
Age of Pet
*
How old was this cat when you acquired him/her?
*
How long ago did you adopt your pet?
*
Including your home, how many homes has this cat had?
*
Sex
*
Male
Female
Unsure
Pet's Color
*
Did this pet receive annual exams by a veterinarian?
*
Yes
No
Unsure
Please provide the name of your pet's veterinarian.
*
Please provide the phone number of your pet's veterinarian.
*
Is this cat current on his/her rabies vaccination?
*
Yes
No
Unsure
Does this animal have any medical problems or previous injuries that require special attention or a special diet?
*
Yes
No
Unsure
Please explain:
Please check all conditions that your cat has been diagnosed with or has been treated for:
If you answered other, please explain.
How does this cat behave at the vet’s office?
*
Check all traits that best describe your feline friend’s personality:
*
If you answered other, please explain.
Does your cat enjoy being:
Check all that apply
Does your cat play with toys?
*
Yes
No
If yes, what kind of toys does your cat prefer?
Does your cat prefer to play with:
Check all that apply
Does this cat have any of the following behavioral issues?
Check all that apply
If you selected aggression, biting, or other, please explain here:
Was this cat kept:
*
Check all that apply
This cat sleeps:
*
Check all that apply
Is this cat litter box trained?
*
Yes, completely
No, has frequent accidents
Mostly, has occasional accidents
Only has accidents while left alone for long periods
If this cat has accidents in the house, have you taken it to a veterinarian to make sure there is not a medical problem?
Yes
No
Has this cat regularly been around children?
*
Yes
No
Unsure
If yes, please indicate the age range of children:
Check all that apply
How does this cat behave around children?
Check all that apply
If you answered other, please explain.
How is your cat with other cats?
Check all that apply
If you answered other, please explain.
How is your cat with dogs?
Check all that apply
If you answered other, please explain.
How does your cat react to strangers?
*
Check all that apply
What would you describe to be the “perfect” home for your cat?
*
Tell us your favorite characteristic about your cat.
*
Does your cat have an behaviors, quirks or habits that you are not fond of?
*
Has this cat ever been aggressive towards people or animals?
*
No, has shown no aggression towards animals or people
Yes, has attacked or bit another person, cat, or other animal
Yes, has hissed at or lunged at another person, cat, or other animal
If you answered yes to the previous question, please explain in detail
Please feel free to add additional comments that you think would be helpful to rescue staff or potential adopters.
How soon do you need to give up this pet?
*
If you schedule the return of an adopted pet and do not show up for your appointment, your pet will still be accepted back; however, they will be added to the end of our wait list if one exists at the time. Wright-Way Rescue schedules the return of pets adopted 8 days or more ago to ensure that we can properly house and care for the animals in our care. We are a no-kill shelter and operate at full capacity. Do you understand Wright-Way Rescue's policies and procedures on returning a pet adopted 8 days or more ago?
*
