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Owner Surrender Questionnaire
Complete this form for surrender of a CAT to Cherokee County Animal Shelter
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Cat's Name
*
Your answer
Sex of Cat
*
Choose
Male
Female
Spayed or Neutered
*
Yes
No
Unknown
Age
Kitten
0
1
2
3
4
5
6
7
8
9
10
Adult
Clear selection
Why are you surrendering your pet?
*
Choose
Moving
Allergies
Not Housebroken
Behavior of pet
No time for pet
Cannot Afford
Health of Animal
Unwanted Litter
Size of Animal
New Baby
Where did you get your pet?
Choose
Adopted from a Shelter or Rescue
Stray
Breeder
Friend/Family
Gift
Newspaper/Internet
Other
Is your pet current on vaccines?
*
Yes
No
Unknown
What is the name of the last vet your pet visited? ***Please bring any medical records you may have.
Your answer
Does this pet have any medical conditions or previous injuries?
*
Yes
No
If your pet has a medical condition, please explain.
Your answer
Has this pet ever bitten a person or other animal?
*
Yes
No
If your pet has bitten, please explain
Your answer
Where did your cat spend most of its time?
*
Choose
Indoors
Outside
Where does your cat sleep?
Your answer
Does your cat have litter box issues?
*
Yes
No
Number of Cats in your home?
*
cat
1
2
3
4
5
6
7
8
9
10
cats
What size/type of litter box do you use?
*
Covered
Uncovered
Automatic
None
Type of Litter? Check all that apply
*
Clay
Scoopable
Crystals
Scented
Unscented
Pine
Other:
Required
What type of food does this pet eat?
Dry
Canned
Dry & Canned
Special Diet (please specify in ADDITIONAL NOTES section below)
Clear selection
Has your cat ever been around other cats?
*
Yes
No
Has your cat ever lived in a home with children?
*
Yes
No
Has your cat ever lived in a home with dogs?
*
Yes
No
Does this pet have any behavior issues or destructive tendencies?
*
Yes
No
If yes to the last question, please explain
Your answer
Have you tried to rehome your pet?
*
Yes
No
How long have you been trying
Day
1
2
3
4
5
6
7
8
9
10
Days
Clear selection
Any other ADDITIONAL NOTES that you would like to share with the staff about your pet:
Your answer
If you are surrendering this pet due to behavior issues, is it your intent that it be euthanized?
Yes
No
Clear selection
Do you understand that when you surrender this animal to us that it is highly possible that we will have to euthanize this animal (put it to sleep)?
*
Yes
No
Your submission will be sent to the intake department of Cherokee County Animal Shelter. You will receive a link to make an appointment after you submit your form.
131 Chattin Drive Canton Georgia 678-493-4387
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