First *
Last *
Address
Street Address *
City *
State *
NV
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AA
AE
AP
ZIP Code *
Email *
Phone *
How did you hear about us?
Tell us your relationship to the cat. *
I am the owner
I am caring for this cat on behalf of the owner
Other
If you are surrendering this cat for someone else, do you have a signed note or power of attorney giving you permission to surrender the cat? *
Yes, I have a signed note
Yes, I have power of attorney
No
Where was the cat obtained? *
Adopted the cat from Homeward Bound
Adopted the cat from another rescue or shelter
Adopted the cat at a PetSmart or Petco store
Got the cat from a friend or acquaintance
Took the cat in off the street
Other
Most rescue organizations will take back cats adopted from them. Have you contacted them to see if they will take back this cat? *
Yes
No
How long can you continue to home the cat? What is your time frame for needing to re-home the cat? *
If you've found a stray cat, chances are it's someone's beloved pet. The owner may be anxiously waiting to hear from you. Take the cat to any veterinary clinic to be scanned for a microchip. Post flyers, ask neighbors, and share on social media to try to reunite the cat with it's owner.
Try these sites:
We do not go out into the community and pick up cats/kittens. We do not have a veterinary clinic. If you see cats/kittens needing immediate help, try these resources:
Are you able to keep the cat/kittens safe until an intake appointment is scheduled, and then bring the cat/kittens to Homeward Bound? *
No Yes
If you answered No, stop here and take the cat(s) to The Animal Foundation or the Henderson shelter, call Animal Control, or contact other rescues. Homeward Bound is not a shelter and cannot take cats on short notice.
Tell us how you got the cat. *
What steps have you taken to try to find the cat's owner? *
How long have you had the cat? *
Please explain why you are surrendering the cat to Homeward Bound Cat Adoptions. *
What steps have you taken to try to re-home the cat before contacting us? Have you tried any of the methods on our Resources page? *
Cat Information
Cat's Name
Cat's age or date of birth *
This cat is *
Male
Female
Unknown
Is the cat spayed or neutered? *
Yes
No
Unknown
Is the cat declawed? *
Not Declawed
Front
All
Does the cat have a microchip? *
Yes
No
Unknown
Microchip Number
Cat Health
Veterinary records help us avoid unnecessary vaccinations and tests.
Has this cat been to a veterinarian? *
Yes
No
Unknown
Date of last vet visit
Name of Veterinarian
Veterinarian Address
Street Address
City
State
NV
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AA
AE
AP
ZIP Code
Phone number of veterinarian
Date veterinary care began
Owner name on vet records
Date of last rabies vaccine
Rabies tag number
Date of last FVRCP (distemper/upper respiratory) vaccine
Tested for FeLV? *
Yes
No
Unknown
Date of last FeLV test
FeLV test result
positive
negative
unknown
Tested for FIV? *
Yes
No
Unknown
Date of last FIV test
FIV test result
positive
negative
unknown
Are you aware of any health issues the cat has? *
No Yes
Please explain.
How does the cat react to going to the vet?
What kind of food does the cat eat? Dry/canned or both? Brand? *
How often do you feed the cat? *
The cat's favorite food/treats
Cat Personality and Behavior
Choose the terms that best describe the cat. *
High energy, kitten-like
Mellow, easy-going
Affectionate
Lap cat
Friendly
Timid
Independent
Talkative
Quiet
Destructive
Scratches/lashes out
Bites
Unpredictable
Can you pet the cat? *
No Yes
Does the cat enjoy being picked up and held? *
No Yes
If no, please explain.
Does the cat use a scratching post? *
Yes
No
Did not provide one
If yes, what type of scratching post?
Rope
Sisal
Corrugated cardboard
Carpet
Other
Does the cat enjoy playing with toys? *
No Yes
If yes, what types of toys?
How many hours a day is the cat indoors? *
How many hours a day is the cat outdoors? *
Does the cat have access to a litter box in the house? *
No Yes
If no, please explain.
Is the litterbox covered?
No Yes
Where is the litterbox located?
How often was the litter box scooped? *
Daily
Every other day
Weekly
Rarely
What type(s) of litter did you use? *
Unscented
Scented
Clumping
Non-clumping
Crystals
Clay
Newspaper\
Pine
Other
If you have other cats, how many shared a litter box?
One
Two or more
Many cats
Multiple boxes for multiple cats
Are litter box accidents an issue? *
No Yes
If yes, when did they begin? *
Please describe the accidents *
Urinates outside of box
Defecates outside of box
Corner of room
Laundry basket
Clothes
Bed
Couch
Rug
Sprays on walls/furniture
Other
How did you deal with the accidents? *
Vet visit
Confinement
Kept outside
Punishment
Other
Has the cat been to a veterinarian to rule out infection or underlying health issue? *
No Yes
If yes, what was the diagnosis?
Date of vet visit
Cat's Experience with Other Animals
Has the cat lived with other cats? *
No Yes
How did they interact?
Adored each other
Played together
Slept together
Ignored each other
Rough with each other
Fought without injuries
Fought with injuries
Peacefully coexisted
Has the cat lived with dogs? *
No Yes
How did they interact?
Adored each other
Played together
Slept together
Ignored each other
Cat feared dog
Dog chased cat
Cat tormented dog
Fought without injuries
Fought with injuries
Peacefully coexisted
Are there other pets in your household? *
No Yes
If yes, what kinds?
Rabbit
Bird
Ferret
Reptile
Other
How do they get along?
Has the cat ever bitten anyone? *
No Yes
When did the bite occur? *
Please explain the circumstances surrounding the bite. *
Cat's Experience with Children
Has the cat been around children? *
Regularly
Visit sometimes
No
How does the cat react to children? *
Cat actively avoids child
Child can pet cat
Mutual adoration
Ignore each other
Cat and child play together
Cat hisses or growls at child
Other
What ages are the children? *
0-2 years
3-5 years
6-10 years
11-18 years
If the cat lived with children under the age of 5, how did they interact?
Cat actively avoids child
Child can pet cat
Mutual adoration
Ignore each other
Cat and child play together
Cat hisses or growls at child
Other
Would you recommend that this cat be placed with children? *
No Yes
If yes, what ages?
Home Life
How would you describe the household the cat lived in? *
Quiet
Average
Active
Noisy
Who is the cat used to living with? *
Adult men
Adult women
Seniors
Children
What areas of your home does the cat have access to? *
Indoors only
Outdoors only
Indoors at night
Indoors with access to outdoors
Garage or basement
Indoors in cold weather
Outdoors in warm weather
Barn or shed
Screened porch
Where does the cat spend most of his/her time when you are home? *
Indoors unconfined
Living room
Bedroom
Kitchen
At the window
Garage or basement
Outdoors
Barn or shed
Wherever people are
Where do you leave the cat when you are gone for portions of a day or evening? *
Indoors unconfined
Living room
Bedroom
Kitchen
Garage or basement
Outdoors
Barn or shed
What arrangements are made for cat care when you are away for more than a day? *
Leave with food and water
Pet sitter
Boarding
Friend/neighbor checks on cat
Other
How does the cat react to being left alone? *
Doesn't mind
Cries/meows
Scratches furniture
House soils
Knocks things down
Other
How does the cat react to visitors?
Very social
Ignores them
Hides
Attacks
Does the cat do any of the following? *
Jumps on counters
Scratches furniture
Chews on plants
Scratches doors/cabinets
Chews personal items
Climbs curtains
Other
Is there anything else we should know about the cat?
You may upload up to 3 photographs of the cat/kittens.
Image 1
Image 2
Image 3
Agreement
If your cat is accepted into our adoption program, we will require an intake fee.
$100 per adult cat
$100-$300 per litter of kittens
Fees help cover the cost of spay/neuter, vaccinations, testing, and other medical treatments. Some cats need dental care or surgery. We also provide socialization and enrichment, grooming, housing, bedding, food, water, litter, and other supplies while working to find new homes for the cats in our care.
By signing this document, I certify that the information I have provided about this cat is true and complete, and I have not willfully concealed information. I hereby forever release, discharge and agree to hold harmless and indemnify Homeward Bound Cat Adoptions, its volunteers and agents from all claims, demands, actions, causes of action, or liability of any kind whatsoever arising as a result of, or in connection with, the adoption or other disposition of the cat described above.
Upon signing this agreement, the owner hereby irrevocably and unconditionally transfers full ownership of this cat to Homeward Bound Cat Adoptions (HBCA). HBCA agrees to accept the above cat into its care and provide the cat with an appropriate standard of care in accordance with its policies and procedures. HBCA has my permission to contact my veterinarian for information pertaining to the cat. I consent to the release of all veterinary records.
(Please sign in the area above the gray line by holding left mouse button and drawing. Draw with finger if using touchscreen.)
Signature *
Clear
First Name *
Last Name *
Date of request submission *