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Give Now To Help Homeless Pets

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OWNER'S INFORMATION

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Street Address:*
City:*
State:*
Zip Code:*
Phone:*
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Email:*
Driver License Number:*
Issuing State:*
Date of Birth:*

PET'S INFORMATION

Cat's Name:*
Breed or description:*
Choose one:*
Male
Female
Is your cat microchipped?*
Yes
No
Don't know
Microchip Number:*
How long have you had this cat?*

CAT'S HISTORY

Select all answers that apply. 

1. Why are you giving up this cat?*
Moving
Behavior issues
Not getting along with people
Not getting along with other pets
Other
Please describe:*
2. Has this cat been around...?*
Cats
Dogs
Only pet
Other
Please describe:*
3. Where is the cat during the day?*
Inside
Outside
Kennel
Other
Please describe:*
4. Where is the cat during the night?*
Inside
Outside
Kennel
Other
Please describe:*
5. If the cat goes outside how does it get out?*
Cat door
Window
Person lets out
Other
Please describe*
6. Does your cat give love bites?*
No
Yes
Hard
Soft
7. Does your cat display any of the following do not pet me behaviors?*
Swishes tail
Twitches ears
Narrows eyes
Growls or tries to bite
8. Does your cat have any areas it prefers not to be touched? *
Back
Tail
Abdomen
Face
Feet
None
9. My cat has bitten or shown aggression towards:*
Adult
Child
Cat
Dog
Nothing
Other
Please describe*
10. Rate your cat's play style with people from 1 (Gentle as a lamb) to 5 (Rough and Tumble):
1 5
11. Has your cat ever shown aggression (bite, growl, snap, shows teeth, etc.) towards a person?*
Yes
No
Maybe
Not sure
12. Has your cat ever injured another animal?*
Yes
No
Maybe
Not sure
13. How does your cat behave with adults?*
Calm
Friendly
Playful
Cuddly
Shy
Plays rough
Fearful
Aggressive
Bites
14. How does your cat behave with children?*
Calm
Friendly
Playful
Cuddly
Shy
Plays rough
Fearful
Aggressive
Bites
15. How does your cat behave with visitors to your home?*
Calm
Friendly
Playful
Cuddly
Shy
Plays rough
Fearful
Aggressive
Bites
16. How does your cat behave with dogs?*
Calm
Friendly
Playful
Cuddly
Shy
Plays rough
Fearful
Aggressive
Bites
17. How does your cat behave with cats?*
Calm
Friendly
Playful
Cuddly
Shy
Plays rough
Fearful
Aggressive
Bites
18. How does your cat behave with livestock?*
Calm
Friendly
Playful
Cuddly
Shy
Plays rough
Fearful
Aggressive
Bites

TERMS AND CONDITIONS

Each pet will be evaluated first during a consultation with an animal care employee at the time of relinquishment and either accepted or denied into our facility based on medical or behavior.

There is no guarantee that we can accept your pet.

Relinquishment fees are due in full If accepted.

CA Penal Code 597s (A): Every person who willfully abandons any animal is guilty of a misdemeanor.

F&A Code 31253: No Charge for fees pertaining to the dog shall be paid by the board of supervisors.

Date:*
Electronic Signature:*

Participant acknowledges and agrees that by clicking the "Electronic Signature" box on the Relinquishing a Pet | Cat Form, it will act as the Participant's electronic signature to this request and you warrant and represent that the information provided is true and accurate to the best of your knowledge.

Submit

Contact a Shelter

Western Riverside: (951) 358-7387 (PETS)
San Jacinto: (951) 358-7387
Coachella Valley: (760) 343-3644
Blythe: (760) 921-7857

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