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GNHCP Online Adoption Screening Form

Every Question Must be Answered, in order to proceed. We will try to contact you by telephone and email. Sometimes this takes up to one week. If you adopt elsewhere, please respond to our efforts to contact you.
Date
Name
Street Address
City, State, ZIP
Home Phone Work Phone Cell Phone
Best phone number and time to reach you
Email
How did you learn about us? (i.e. Google, friend's name, Petfinder, Adopt A Pet)
Have you owned a cat before? Yes No
Have you lost a cat? Yes No
Did a previous cat die? Yes No
If yes, How?
Why do you want to adopt a cat/kitten now?
Are you looking for anything specific: male/female, cat or kitten, long or short hair, particular color?
Would you consider an older cat, more than one cat, a diseased or abused cat? Yes No
Do you live by yourself or with others?
Are all of the adults in agreement about adopting a cat? Yes No
If there are children, what are their ages?
Is anyone in the household allergic to cats? Yes No
What would you do if someone became allergic?
Do you own or rent?
If you rent, does your landlord allow pets? Yes No
Will you provide a copy of your lease with pet provision or a rental permission form completed by landlord?
Yes No
How long have you lived at this address?
What would you do with the cat(s) if you had to move?
Do you have any pets now? Yes No
If Yes, what type of pets do you own?
Are you willing to allow up to 4 months for your new cat to adjust to its surroundings? Yes No
Who is your veterinarian?
How often do you bring your pet(s) to the vet?
Will you give GNHCP permission to contact your vet? Yes No
If no, why?
What are your work hours and the work hours of others you live with?
Reference (not a family member) 
Name     Address
Telephone number
Would this be an indoor, indoor/outdoor, or outdoor cat?
Do you plan to declaw the cat? Yes No
Are you willing to make a long-term commitment to the care and maintenance of this cat? Yes No
If the cat were to become lost, what would you do?
Is there anything else about yourself that you would like to tell us?