Cat Intake Form - San Francisco SPCA

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Cat History Form (Intake)

This form is for clients who wish to return an animal adopted from the SF SPCA

"*" indicates required fields

Guardian Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Cat's Name*

How long have you had this cat?*

Less than 30 days

More than 30 days

Cat's Sex*

Male

Female

Is this cat spayed/neutered?*

Yes

No

Why are you giving up your cat?*

Moving

Allergies

Litterbox

New baby

Biting/scratching

No time

Not getting along with other pets

Not getting along with family members

Behavior issues

Other

Please elaborate on your cat not getting along with other pets:*

Please elaborate on your cat not getting along with family members:*

Please elaborate on your cat's behavior issues:*

Please elaborate on any other reason why you are giving up your cat:*

How did you obtain this cat?

SF SPCA Adoption

Newspaper/Internet

Found stray

Friend

Breeder

Gift

Other Shelter/Rescue

What shelter/rescue did you obtain this cat from?*

How was your cat raised?*

With children

Quiet, adult home

With dog(s)

With cat(s) and dog(s)

Single cat

With other cat(s)

Where is the cat kept at the home?

Where does this cat spend its time?*

Inside only

Outside only

Outbuilding (garage, shed)

Inside and Outside

When is this cat inside?*

When is this cat outside?*

If this cat goes outside, how does it get out?*

Cat door

Window

Person lets out

Other

Please explain other:*

Is this cat is restricted to/from any areas?*

Yes

No

Please explain:*

Where does this cat sleep at night?*

Inside

Outside

Where does the cat sleep inside?*

With whom?*

Where does the cat sleep outside?*

With whom?*

Does this cat have any favorite daytime perching spots?*

When alone, has the arrangement above been successful?*

Yes

No

Explain no:*

Feeding Information

What type of food does this cat eat?*

Dry kibble only

Canned food only

Dry & canned

Special diet

What brand of kibble?*

What brand of canned food?*

Please explain the cat's special diet:*

How often does this cat eat?*

Once daily

Twice daily

Free fed

How much does this cat eat in a day?*

Does this cat have any favorite treats?*

Exercise, Play and Behavior Information

Does this cat receive regular play time with people?*

Yes

No

What types of items does this cat play with?*

Cat toys

String

Feathers

Balls

Bugs, birds, mice, etc.

Other

Please explain other:*

Does this cat use a scratching post?*

Yes

No

What type of surface does your cat prefer to scratch on?*

Cat tree

Carpet

Vertical/upright surfaces

Scratching post

Upholstery

Cardboard scratcher

Wood

Horizontal/flat surfaces

Jumping on people

Drapes/curtains

Other

Please explain other:*

Is this cat’s activity level:*

Low energy

Medium energy

Extremely active

Is this cat most active:*

Daytime

Nighttime

Both

Does this cat have any areas it doesn’t like to be touched?*

Back

Tail

Other

Please explain other:*

What makes this cat nervous, or causes it to behave in a different manner than usual?*

Men

Women

Children

Strangers

Going to the vet

Going in the car

Cat carriers

Bathing

Brushing

Nail clipping

Other cats

Other animals

Other

Please explain other animals:*

Please explain other:*

Does this cat have a preference for?

Men

Women

Children

Animals

What kind of animals?*

How would you describe this cat overall?*

Calm

Friendly

Playful

Curious

Vocal

Cuddly

Clingy

Outgoing

Standoffish

Shy

Fearful

Confident

Dependent

Independent

Aggressive

Other

Please explain other:*

Litter Box Information

Number of cats in your home?*

Number of litter boxes in your home?*

What type of litter box do you use?*

Covered

Uncovered

Other

Type of litter? [check all that apply]*

Clay

Pine litter

Pellet

Crystals or pearls

Scoop-able

Scented

Unscented

Other

Please explain other:*

When is the litter box scooped?*

Daily

Weekly

Monthly

When it smells bad

When is the litter box dumped?*

Daily

Weekly

Monthly

When it smells bad

When is the litter box cleaned?*

Daily

Weekly

Monthly

When it smells bad

What do you use to clean the litter box (bleach, pine sol, detergent, exyme, etc.)?*

Where is the litter box located? [check all that apply]*

Main floor

Second floor

Basement

Bedroom

Laundry room

Kitchen

In a closet

Under furniture

Bathroom

Outside

Is your cat litter box trained?*

Yes

No

If no, explain:*

Has this cat ever had an accident outside the litter box?*

Yes

No

What kind of accident?*

Urine

Feces

Both

If yes, where was the accident? [check all that apply]*

Next to the box

On carpet or rug

On clothes/towels/bedding

On furniture

In bathtub/shower

Spraying on vertical surface

On tile/wood/concrete

Other

Please explain other:*

How often were these accidents?*

Daily

Few times a week

Couple of times a month

Monthly

Few times a year

Other

Any recent changes in household or routine that might have triggered the problem?

Moved

New baby

Work hours

New pet

Construction

Has this cat seen a veterinarian for this problem?*

Yes

No

Was the problem resolved?*

Yes

No, ongoing problem

Only occasional relapse

Veterinarian Information

Name of Veterinarian or Clinic:

Date of last visit:

Current on vaccinations?

Yes

No

Other information

Please add any additional information that you feel would be helpful for us, or a new owner. This will help us make the best possible match with a new home.

Please describe the ideal home you would like for this cat:*

Upload Files

Upload Medical Records & Photo

Drop files here or

Max. file size: 50 MB.

Please upload any digital copies of medical records below. If you are unable to upload directly, please bring any physical copies to your surrender appointment.

85357

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