From the moment your cat enters our shelter, it will be treated more like
a guest than a homeless animal. Our cats receive the best medical care,
are beautifully groomed, eat only premium quality food, and enjoy a
beautifully furnished and comfortable environment – and of course, are
given lots of love! Because we receive no funding whatsoever we must rely
heavily on donations which allow Atlanta Persian and Siamese Rescue to
properly care for all cats in our care.
UPON ACCEPTING YOUR CAT INTO OUR
INTO OUR RESCUE PROGRAM, WE REQUIRE A DONATION. IN MOST CASES, THE MINIMUM
DONATION AMOUNT IS $100 IF YOU CAN PROVIDE VET RECORDS SHOWING THAT YOUR
CAT IS SPAYED/NEUTERED, FELV/FIV NEGATIVE, UP TO DATE ON ALL VACCINATIONS
AND IN GOOD OVERALL HEALTH. OTHERWISE, THE REQUIRED DONATION AMOUNT WILL
BE GREATER. THE DONATION WILL BE USED FOR GENERAL, VETERINARIAN, AND
POSSIBLE LONG-TERM CARE OF YOUR CAT.
Please complete all information below as
thoroughly as possible. By doing so, you will help us to better assess
your cat so that we may match it with the proper potential adopter.
I. GENERAL INFORMATION (Please Print):
Your Name:
___________________________________________________________________________________
Address:
_______________________________________________________________________________
City: _______________________________________________ State______________
Zip______________
Home Phone: _________________________________ Work
Phone:_______________________________
Email:
____________________________________________________________________________
Cat Name:
____________________________________________________________________________________
Sex: □ Male □ Female
Spayed/Neutered: □ Yes □ No
Declawed: □ Yes □ No
Breed (if mix, please indicate what the mix might be):
__________________________________________________
Color:
________________________________________________________________________________________
Birthdate or Age of Cat: ________________________ Age at
Adoption/Purchase: ___________________
Weight of Cat:
_________________________________________________________________________________
Where did you originally get your Cat? □ Breeder □ Shelter/Rescue Group
□ Friend/Family □ Pet store
□ Kennel □ Found/Stray
How did you find APSR?:
________________________________________________________________________
II. SPECIFIC INFORMATION: The more we know about your Cat, the better job
we can do of finding
the best possible home for it. Please answer the following questions as
completely as possible.
Current family includes (please give children’s ages):
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Do you have other animals? (type, gender, age):
_________________________________________________________
Does your Cat like:
Water (circle one)
Doesn't Somewhat
Tolerates Likes
Loves
Dogs (circle
one)
Doesn't
Somewhat
Tolerates
Likes Loves
Other Cats (circle one)
Doesn't Somewhat
Tolerates Likes
Loves
Children (circle one)
Doesn't Somewhat
Tolerates Likes
Loves
Baths (circle
one)
Doesn't
Somewhat
Tolerates
Likes Loves
Car Rides (circle one)
Doesn't Somewhat
Tolerates Likes
Loves
Being Brushed (circle one) Doesn't
Somewhat Tolerates
Likes Loves
Strangers (circle one)
Doesn't Somewhat
Tolerates Likes
Loves
Elaboration on Likes/Dislikes:
______________________________________________________________
______________________________________________________________________________________
---------------------------------------------------------------------------------------------------------------------------------------------
Does your cat use its litter box:
□ 100% of the time
□ 50-75% of the time
□ Less than 50% of the time
Your Household activity level: □ Quiet □ Active □ Very Active
III. MEDICAL:
Do you have a local Veterinarian? □ Yes □ No
Name __________________________________________________________________
Address ________________________________________________________________
Phone _________________________________________________________________
Note:We require ALL
Veterinary records to accept your cat in our
shelter.
You must MAIL these records.
Is the Cat currently on:
Maintenance medications? □ Yes □ No If yes, type:
_________________________________
Preventative medications? □ Yes □ No If yes, type:
_________________________________
Special diet? □ Yes □ No If yes, type: __________________________
How many meals per
day?________________________________________________________________________
Amount at each feeding?
_________________________________________________________________________
Where does Cat eat?
____________________________________________________________________________
Where does Cat sleep?
__________________________________________________________________________
Describe Cat’s general temperament:
_______________________________________________________________
Has this Cat ever shown fear?
____________________________________________________________________
Has this Cat ever bitten a person or other animal?
________________________________________________________________________________
Why are you unable to keep this Cat?
_______________________________________________________________
Additional Comments:
___________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
WE REQUIRE A
DONATION AT THE TIME OF SURRENDER WHICH HELPS DEFRAY THE COSTS OF ANY
VETERINARY EXPENSES, GENERAL CARE AND POSSIBLE LONG TERM CARE OF YOUR CAT.
PLEASE BE GENEROUS!
BY SIGNING THIS FORM, I UNDERSTAND THAT ANY FUTURE PLACEMENT OF THE CAT I
AM SURRENDERING TO ATLANTA PERSIAN AND SIAMESE RESCUE IS STRICTLY
CONFIDENTIAL AND I WILL BE PROVIDED NO INFORMATION CONCERNING FUTURE
ADOPTION. I AGREE TO FURNISH ALL VETERINARY RECORDS.
I WILL BE MAKING A DONATION TOWARDS THE CARE OF MY CAT IN THE AMOUNT OF
$________________
______________________________________________________
_________________________
Signature
Date
BEFORE WE CAN ACCEPT YOUR CAT INTO
OUR PROGRAM, YOU WILL NEED TO
MAIL ALL VETERINARY RECORDS AND A RECENT PHOTO OF THE CAT TO:
ATLANTA PERSIAN & SIAMESE RESCUE
3705 NEW MACLAND ROAD
PMB 200 / 148
POWDER SPRINGS, GA 30127
AS SOON AS WE RECEIVE THIS INFORMATION, WE WILL CONTACT YOU.
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