Adoption Application Cat Adoption Form Multi-page adoption intake form with conditional logic, references, and agreement section. Step 1 of 5 20% X/TwitterThis field is for validation purposes and should be left unchanged.Are you interested in a specific cat?(Required) Yes No If Yes, what is the Cat's Name?(Required)DollyAbout YouPlease provide your primary contact and household information.Name(Required) First Last Age(Required)SelectUnder 1818-2122-2425-3435-4445-5455-6465-6970-74Over 75Address(Required) Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Cellphone Number(Required)Home PhoneEmployment Status(Required)EmployedSelf-EmployedRetiredIn SchoolOn DisabilityUnemployedOtherIf employed, are you full-time or part-time?(Required) Full-time Part-time Are there any other adults living in the home?(Required) Yes No How many additional adults live in the home (excluding yourself)?(Required)Select1234Additional Adult 1Name(Required) First Last Relationship(Required)Employment Status(Required)EmployedSelf-EmployedRetiredIn SchoolOn DisabilityUnemployedOtherAdditional Adult 2Name(Required) First Last Relationship(Required)Employment Status(Required)EmployedSelf-EmployedRetiredIn SchoolOn DisabilityUnemployedOtherAdditional Adult 3Name(Required) First Last Relationship(Required)Employment Status(Required)EmployedSelf-EmployedRetiredIn SchoolOn DisabilityUnemployedOtherAdditional Adult 4Name(Required) First Last Relationship(Required)Employment Status(Required)EmployedSelf-EmployedRetiredIn SchoolOn DisabilityUnemployedOtherChildren SectionAre there children under 18 in the home?(Required) Yes No How many children under 18 live in the home?(Required)Select1234Child 1Name(Required) First Name Age(Required)Will the child be monitored until the cat and child are comfortable with each other?(Required) Yes No Child 2Name(Required) First Name Age(Required)Will the child be monitored until the cat and child are comfortable in the home?(Required) Yes No Child 3Name(Required) First Name Age(Required)Will the child be monitored until the cat and child are comfortable in the home?(Required) Yes No Child 4Name(Required) First Name Age(Required)Will the child be monitored until the cat and child are comfortable in the home?(Required) Yes No Do you rent or own your home?(Required)OwnRentLandlord InformationIf you rent your home, please provide your landlord’s contact information below.If you rent, does your landlord allow pets?(Required) Yes No N/A Current PetsPlease provide details about any pets currently in your home.Do you currently have any cats?(Required) Yes No How many cats do you have?(Required)Select1234Cat 1Name(Required) Name Age(Required)Sex(Required) Female Male Is the cat spayed/neutered?(Required) Yes No Is the cat up-to-date on vaccines?(Required) Yes No Is the cat indoor only, outdoor, both?(Required) Indoor Only Outdoor Only Both, Indoor & Outdoor Cat 2Name(Required) Name Age(Required)Sex(Required) Female Male Is the cat spayed/neutered?(Required) Yes No Is the cat up-to-date on vaccines?(Required) Yes No Is the cat indoor only, outdoor, both?(Required) Indoor Only Outdoor Only Both, Indoor & Outdoor Cat 3Name(Required) Name Age(Required)Sex(Required) Female Male Is the cat spayed/neutered?(Required) Yes No Is the cat up-to-date on vaccines?(Required) Yes No Is the cat indoor only, outdoor, both?(Required) Indoor Only Outdoor Only Both, Indoor & Outdoor Cat 4Name(Required) Name Age(Required)Sex(Required) Female Male Is the cat spayed/neutered?(Required) Yes No Is the cat up-to-date on vaccines?(Required) Yes No Is the cat indoor only, outdoor, both?(Required) Indoor Only Outdoor Only Both, Indoor & Outdoor If you do not currently have cats, have you had cats in the past or do you have experience with cats? (Please describe)(Required)Dog SectionDo you currently have any dogs?(Required) Yes No How many dogs do you have?(Required)Select123Dog 1Name(Required) Name Age(Required)Sex(Required) Female Male Is the dog spayed/neutered?(Required) Yes No Is the dog up-to-date on vaccines?(Required) Yes No Does the dog have experience with cats?(Required) Yes No Dog 2Name(Required) Name Age(Required)Sex(Required) Female Male Is the dog spayed/neutered?(Required) Yes No Is the dog vaccinated?(Required) Yes No Does the dog have experience with cats?(Required) Yes No Dog 3Name(Required) Name Age(Required)Sex(Required) Female Male Is the dog spayed/neutered?(Required) Yes No Is the dog vaccinated?(Required) Yes No Does the dog have experience with cats?(Required) Yes No Other Pets SectionDo you currently have any other pets in your home?(Required) Yes No How many other pets do you have?(Required)Select12Other Pet 1Name(Required) Name Type(Required)Other Pet 2Name(Required) Name Type(Required) Adoption ReadinessPlease review the following statements carefully before proceeding.Do you or anyone in your home smoke (tobacco, marijuana, vaping or other)?(Required) Yes No Have you considered care arrangements if you go away?(Required) Yes No Do you or anyone in your household have health issues that could affect adoption?(Required) Yes No 'Please explain how you and your family plan to work around these concerns (e.g., mild cat allergies managed with medication).(Required)Have you considered the cost of food and litter for a cat?(Required) Yes No What amount are you prepared to spend on unexpected veterinary care if needed?(Required)$200 – $500$501 – $1,000$1,001 – $2,500$2,500 – $5,000More than $5,000Cats can live 15–20 years. Are you prepared to make a long-term commitment for the lifetime of the cat?(Required) Yes No Have you ever surrendered or rehomed a pet?(Required) Yes No If yes, please explain the circumstances.(Required)Is there anything else you would like to let us know? References & AgreementPlease provide a personal reference (first & last name), their relationship to you and their contact information. It can be a family member that does not live with you or a friend that you have known for at least 3 years as long as we can confirm the reference’s contact information publicly, i.e. through the phonebook, a website or social media.Personal Reference Full Name(Required)Personal Reference Phone Number / Social Media / Public Info(Required)Relationship to You – Minimum 3 years and does NOT live with you.(Required)Do you currently have a veterinarian?(Required) Yes No Veterinary Clinic InformationPlease provide your veterinary clinic’s contact information and ensure they have permission to speak with us regarding your pet history.Veterinary Clinic Name(Required)Veterinary Clinic Phone Number(Required)Veterinary Clinic Address (Optional) Adoption AgreementYou must also agree to the terms below before submitting your application.Please confirm the following:(Required) I agree to treat this cat humanely and will not use or donate the cat for experimentation or research. I will not abuse, neglect, mutilate, or harm the cat in any way. I understand that declawing is a painful and harmful procedure that can cause lifelong physical and behavioral issues. I agree that I will not declaw the cat. I understand that free-roaming outdoor cats face significant risks, including injury, disease, vehicle accidents, and harm from other animals or people. I agree that this cat will not be allowed to roam freely outdoors. I confirm that all information provided in this application is true and accurate to the best of my knowledge. Finding the best home for a cat or kitten is Hearts to Homes Feline Rescue & Sanctuary’s top priority. I understand that submitting this application does not guarantee adoption and that Hearts to Homes Feline Rescue & Sanctuary reserves the right to refuse an application at its sole discretion Please check each box to confirm you understand and agree.Privacy & Consent Privacy Statement We respect your privacy. The information collected in this application is used to confirm the identity of individuals wishing to adopt a cat or kitten and to help determine the suitability of placing a cat or kitten in your home. Your personal information, along with details about the cat being adopted, will be stored in both paper and electronic records maintained by Hearts to Homes Feline Rescue & Sanctuary. This information may also be shared with the microchip company selected by Hearts to Homes Feline Rescue & Sanctuary for the purpose of registering your adopted cat’s microchip. Hearts to Homes Feline Rescue & Sanctuary does not sell or distribute client or adopter information. Personal information will not be shared with third parties except as required for the adoption process described above. From time to time, we may contact you using the information you have provided to share updates, request support, or inform you about events organized by Hearts to Homes Feline Rescue & Sanctuary. By submitting this form you confirm that you have read and agree to all terms, conditions, and the privacy statement above.
