Cat Guardianship Form Pet Guardianship Cat Enrollment Form Thank you for taking the responsible step to enroll your beloved pet in Yavapai Humane Society’s Pet Guardianship Program. Cats can’t talk, so they can’t tell us where or with whom they would like to live. To ensure that their home is a safe, happy & appropriate place for your cat to live, we need you to fill out this form in as much detail as possible. Detail & honest information from you is crucial to our placement process, so please take the time to fill in this profile with care & accuracy. Undesirable behaviors & medical issues do not necessarily create problems, however, not disclosing those problems definitely does. Inaccurate or incomplete responses can undermine the safety & happiness of both your cat & the new adopting family. If there are any questions that are unclear or that you are uncomfortable responding to for any reason, please ask to speak directly to one of our helpful staff about the issue.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastPhone *Email *Address *Cat's Names *Vaccinated within the past year?YesNoIf vaccinated, which veterinary facility?Cat's Age *Sex *Male neuteredMale un-neuteredFemale neuteredFemale un-neuteredIs your cat declawed? *YesNoNot sureHow long have you owned this cat? *Where did you obtain this cat? *Yavapai Humane SocietyOther shelterBreederPet storeFriendFoundRescue groupNewspaperOtherChoice 5To your knowledge, how many homes has this cat had before living with you? *Please list the ages and sexes of the people this cat has lived withWould you recommend placing this cat in a home with children under 10 years of age? *YesNoNot sureWhy or why not?If this cat lived with children under 10 years of age, how did they interact? *Actively avoided childGrowled / Hissed at childChild could pet the catIgnored each otherPlayed togetherGentle / AffectionateUnknownOtherCheck all that applyPlease tell us what other animals your cat has lived with *Male cat(s) un-neuteredMale cat(s) neuteredFemale cat(s) un-spayedFemale cat(s) spayedDogsNever lived with other animalsOtherCheck all that applyHow does this cat behave with other cats in your home or outside of your home? *BulliesFrightenedFriendly / PlayfulNever around other catsGrowls / HissesShyCuriousIgnoresUnknownOtherCheck all that applyWould you recommend placing this cat in a home with other cats? *YesNoNot sureWhy or why not?How does this cat interact with dogs? *ChasesCuriousFriendlyGrowls / HissesFrightenedIgnoresGentleNever around dogsUnknownOtherCheck all that applyIs your cat litter box trained? *YesNoNot sureWhat brand of litter does your cat prefer?Has the cat ever inappropriately eliminated?YesNoNot sureWhere does the cat reside? *Inside onlyInside / OutsideOutside onlyBarn catWhat toys does he/she like to play with? *How many hours a day is your cat left alone? *More than 10 hours8-10 hours5-8 hours0-4 hoursNever left aloneOtherAre there any particular people or things that your cat appears to be afraid of? *MenWomenChildrenDogsCatsPeople in uniformsStrangersVacuums / BroomsCars / TrucksWaterThunderstormsLoud NoisesNoneOtherWhat does your cat do that leads you to believe he/she is afraid?Has your cat everBittenHissedGrowledScratchedOtherCheck all that applyWhat made them behave this way?FoodRough playToysStrangersChildrenAdultsOther AnimalsOtherDoes your cat have any current, previous or recurring medical or behavioral problems?Please describe in detailWhat medication is your cat currently taking?What part of your cats body does he/she not like touched?FeetBackLegsHeadTailMouthBellyOtherCheck all that applyHow does he/she respond?SnapsGrowlsLungesUrinates / DefecatesStruggles / Attempts to escapeCowersOtherCheck all that applyWhat is the name of your veterinarian/veterinary clinic? *What brand and type of food have you been feeding your cat? *Digital Signature (type first and last name) *I certify I have the authority to enroll the above described animal in the Pet Guardianship Program. Upon my death or incapacitation, I hereby relinquish all rights of ownership, in the above-described animal(s) in favor of Yavapai Humane Society, and I agree that the animal(s) may be placed up for adoption, transferred to another animal welfare organization or humanely euthanized at the sole discretion of Yavapai Humane Society. I authorize the transfer of my animal’s information (as listed above) to a new owner when this animal is placed up for adoption. The information on this form is to the best of my knowledge, accurate & complete. I understand that every effort will be made to place the animal in a foster home while it awaits adoption, but it may be housed temporarily in the YHS Adoption Center. I understand that YHS will attempt to place my animals in the same home but also understand the most important thing is to have them in a loving home, even if it means they are separated.Date *Submit
