Cat Adoption Survey
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Please complete the following information and click the Save button at the end of the form. The information will be emailed to a FieldHaven Adoption Counselor who can assist you in finding the best match for you and your family..
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Full Name (Req):
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Address (Req):
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City (Req):
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State (Req):
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Zip Code (Req):
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Phone (Req):
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Email (Req):
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About You & Your Household
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Cat Experience
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Never had a cat
Grew up with cats
1-3 cats as an adult
Many cats as an adult
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Household Members
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Adults 18-21 yrs
Adults 22-60 yrs
Adults over 60 yrs
Children under 18 yrs (See Below)
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Please list the ages of all children under age 18
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Home Environment
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Quiet/Calm
Moderate
Active
Lively
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Cat Will Be Alone
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Rarely (Someone is always home)
Part-time (Alone 3-5 hr/day)
Full-time (Alone 6-8 hrs/day)
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Cat Will Live
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Inside
Inside/Outside
Outside
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Housing Type
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House
Apartment/Condo
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Do you rent or own your home?
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*Rent/Lease
Own
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*Landlord's Name and Phone No.
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Is anyone in your household allergic to animals?
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Yes
No
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Have you previously adopted from a shelter?
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Yes
No
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Please list any bad kitty habits that you just cannot tolerate.
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Under what circumstances, would you not be able to keep a cat after adopting?
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Description of Your Ideal Cat
(check all that apply)
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Age
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Kitten (2-6 mo)
Juvenile (7-18 mo)
Adult (16 mo-5 yrs)
Mature (5+ yrs)
No Preference
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Coat
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Short
Medium
Long
No Preference
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Energy Level
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Low
Medium
High
No Preference
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Gender
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Female
Male
No Preference
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Current Pets
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Please list the species, breed, gender, age, and how long you have had each pet.
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Are all pets Spayed/Neutered?
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Yes
No
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If No, please explain why.
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Recent Pets
(last 10 years)
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Please list the species, breed, gender, age, and how many years you had each pet.
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Were all pets Spayed/Neutered?
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Yes
No
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If No, please explain why.
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Are there any cats on currently listed on our website that you are interested in?
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How did you hear about FieldHaven?
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I certify that the information I have provided is true and correct to the best of my knowledge, and I understand that false information may void my survey. I understand that FieldHaven's main concern is that all pets be properly cared for by their owners.
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Certification
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I Agree
I Do Not Agree
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After clicking "Save", you will be prompted to "Print" your survey. To save time, we suggest you bring a printed copy with you when visiting one of our outreach locations such as PetSmart or Petco as we do not have computer access at those locations.
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Thank you for your interest in adopting a companion from FieldHaven. An adoption counselor will contact you shortly.
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