Surrender or Return

Surrender or Return - Cat

Animals brought to HSMC, who have been in a household and are being surrendered

Surrender / Return Cat Please be as specific as possible. Thank you for your open and honest answers. Your donation to cover costs while in our care, is greatly appreciated. YOU WILL RECEIVE AN IMMEDIATE EMAIL RESPONSE WHEN YOUR APPLICATION IS Submitted.

Today's Date:
Was pet adopted from Helping Strays: *
Owner first name: *
Last name: *
Surrendered by agent, if different than owner:
Address: *
City: *
State: *
Zip: *
Cell/phone: *
Email:
Confirm email
Cat’s Name *
Sex *	Female Male
Approx Age: *
Breed *
Fixed (Spayed/Neutered) *
Approx Date Fixed:
Why are you surrendering (please note any behavioral issues): *
How long has the cat lived with you: *
Any special medical or dietary needs (include medications and food given): *
Any previous health issues or injuries (surgeries, seizures, fractures, allergies, etc):
Current on Vaccinations - PLEASE PROVIDE COPY OF MOST RECENT VET RECORDS: *
Date last Vet visit, Vet's name/phone #: *
Has your cat bitten someone severly enough to require medical attention: *
Specifics of what provoked the incident: *
Does cat have litter box issues: *
If yes, please explain:
Other animals your cat has lived with and how did they interact: *
Where does your cat predominantly live:	Inside Outside Both
Where do you leave your cat when no one is home:	Outside Free inside Confined to a room In a crate/carrier
Check all words describing your cat: *	Calm Friendly Energetic Independent Playful Fearful/shy Anxious Confident Aggressive
What do you feed your cat / How often / How much: *
Information you wish to share about your cat:
I, owner/agent of said animal relinquish all rights of ownership, understand that Helping Strays personnel are under no obligation to release any information regarding the disposition of said animal, and give shelter permission to contact any veterinarians or animal care facility regarding the medical records of said animal. Owner Signature: *

YOU WILL RECEIVE AN IMMEDIATE EMAIL RESPONSE WHEN YOUR APPLICATION IS Submitted.