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Helping cats one tattered tail at a time

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Intake Form

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Please complete the form in it’s entirety.

Date *

Please enter today's date.

Name *

First

Last

Phone Number *

Email *

Address *

Please enter your home address.

Number of Cats Needing Placement

Please explain why you need to surrender your cats *

Are you the lawful owner of the cat(s)? *

Yes
No

Are you willing and able to provide the intake/testing fees? *

Yes
No

Cat's Name *

Cat's Age

Cat's Breed

Cat's Gender

Male
Female

How long have you had the cat(s)?

If you adopted the cat(s) are you able to provide adoption records?

Yes
No

Is the cat spayed or neutered? *

Yes
No

Is the cat

Indoor Only
Outdoor Only
Both

Has the cat been seen by a veterinarian within the past six months? (Can you provide medical records?)

Current Vaccinations *

Rabies
FVRCP
FIV
FeLV
Not Sure

Has the cat been tested for FIV? *

Yes
No
Not Sure

Has the cat been tested for FeLV? *

Yes
No
Not Sure

When was the cat tested for FIV or FeLV?

Approximate date to the best of your knowledge.

Please explain any health issues your cat has, if any.

Is your cat currently taking any medications, or previously?

Yes
No

Does your cat have a history of dental problems?

Yes
No

What sort of food does your cat eat?

Has your cat had any surgeries? If yes, please explain what type and when.

Does your cat urinate or defecate outside of the litter box?

Yes
No

If yes, have you spoken to a veterinarian to rule out a medical condition?

Yes
No

Cat Behavior Traits

Shy
Friendly
Good with children
Aggressive towards other cats
Lap cat
Aggressive towards humans
Feral/Unsocialized
Afraid of other cats

Is the cat comfortable with people handling him/her?

Yes
No

Has the cat ever bitten your or others in your household?

Yes
No

Are there other animals in your household?

Yes
No

There is an intake fee of $150 per cat/ kitten or a $125 intake fee for a litter of kittens, plus a $25 per cat/kitten FIV/Felv test fee.

Please fill our a separate form for each cat. One form for a litter of kittens. Our Intake Coordinator will contact you after reviewing your application. This can take a few days. If we are unable to take you cat, we will provide you with other possible resource information.

Kattered Tails
Helping cats one tattered tail at a time
Chandler, AZ 85226
See Contact Us page for rescue phone numbers.

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