Cat Adopter Information Form

Cat Adoption Application

Thank you for your interest in adopting a pet and for taking the time to fill out this questionnaire. Please allow our volunteers several days to contact your references. We will contact you once we make a decision. Thank you so much for considering a rescue! (Fields with a red asterisk are required.)
Personal Information
Applicant's First Name *
Applicant's Last Name *
Please list the ages and relationship of those who live in your home. *
Street Address *
Apartment Number (if applicable)
City *
State *
Zip Code *
Best Contact Phone Number *
Email Address *
What is the best way to reach you? *
Occupation *
Employer Name
Name of School
Other: Please Explain
I am at least 18 years of age. *
Adoption Preferences
Is there a particular cat of ours that you are interested in? If so, provide name and description:
Gender
Age range (select all that apply)
What characteristics are you looking for in a cat (e.g., friendly with cats or dogs, good with kids, independent, calm, sociable, good mouser, cuddly, fur color/pattern, polydactyl, long- or short-haired, etc.)?
Home Information
If anyone in your household is allergic to cats, will this be a problem? *
Do all the adults in your household know that you are considering adopting a pet? *
If you rent, please provide the name and number of your landlord.
Will this pet be predominantly living inside, outside, or both? *
What is the household setting?
If outside or both, how long after adoption would you start letting the cat go outside?
IMPORTANT: FCHS recommends keeping a new cat indoors for a minimum of 4 to 8 weeks until they adjust to their new home (longer for kittens). Make sure the cat cannot get out. Secure all doors and windows, and check all latches and door knobs to be sure a smart cat cannot open them.
Where will the cat spend the night?
On average, how many hours per day will your pet be left alone? *
What is your plan for the cat in the event of an extended emergency or if you were no longer able to care for him/her? *
Problem Resolution
What problem(s) would cause you to return a cat? (Please select all that apply.) *
If "Other", please describe:
Are you and your family willing to work with us (and the cat) to overcome or correct potential behavioral challenges? *
Have you ever had to surrender a pet that you owned to a pet shelter or animal control? *
If yes, please describe where you surrendered the pet and the circumstance?
Pet Care and History
List all animals that you currently have (type of animal, name, age, vaccinations, spayed or neutered) *
Please list all animals you have owned within the last 5 years and describe what happened to them. *
Do you plan to declaw this cat? *
Veterinarian info
Name and telephone number of current (or previous) veterinarian that treats or treated your animals for the past 2 years. * (If you have never owned a pet please tell us where you would go?)
References Please list names and email addresses and phone numbers for three personal references, other than relatives. If you’ve had pets, include references who know the pets you have or have had, and the care that you provide for your pets:
Reference 1 *
Reference 2 *
Reference 3 *
Please share any further information that you would like to add that is related to adopting a cat.
Closing Questions and Terms
I consent to a home visit before adoption if needed. *
Have you ever been charged or convicted of animal cruelty, neglect, or abandonment? *
Please describe the nature of the charge(s)

Other Terms
Cost of Pet Care: I understand that on average, the annual cost to feed, house and provide medical care for a cat can range from $500 to $1000 or more. *
Declawing: I understand that declawing a cat is strictly forbidden. Declawing is a painful and cruel surgical procedure that FCHS does not permit on cats we offer for adoption. It is further prohibited by Virginia Code § 54.1-3814. *
Spay and Neuter Requirement: Floyd County Humane Society (FCHS) requires that you spay or neuter any kitten you adopt before 6 months of age. You must provide FCHS with a veterinary certification of altering by the date specified in the adoption contract. We reserve the right to repossess cats unaltered by the contractual date. * (Note: The adoption fee includes a reimbursement for spay/neuter at the veterinary office of FCHS choice and any age-appropriate vaccines at the time of adoption and/or flea treatment and dewormer if necessary).
Follow Up After Adoption: I understand that FCHS representatives may contact me after an adoption to ensure that the cat successfully adjusts to his or her new home. *
If at any time an adopter cannot keep a cat, he or she must be returned to FCHS. *

By signing below, I acknowledge that I have completely read this application and comprehended it fully. I know that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application or the adoption contract can result in the forfeiture of any Floyd County Humane Society animal adopted by me.
Please Initial Here & Date *

Updated February 10, 2026