Every Life Matters (ELM) Cat Rescue Inc.
Adoption Questionnaire
Every Life Matters Cat Rescue’s primary goal is to ensure the safety, health, and happiness of every feline that we bring into
our care. To help us get a sense of each new potential family, we appreciate the time you will take to fill out the following
questionnaire. Please answer each and every question truthfully and to the best of your ability.
On occasion, some felines may not be a good fit with a particular family. Because of this, we reserve the right to decline any
adoption that is not in the best interests of our rescue cat(s) and/or the potential family.
Full Name: ________________________________________________________________________________________
Street Address: _____________________________________________________________________________________
_________________________________________________________________________________________________
Mailing Address (if different from above): _________________________________________________________________
_________________________________________________________________________________________________
City: _________________________________________
Province: __________________
PC: ________________
Phone #s - Home: ___________________________________
Cell: _____________________________________
Work: _____________________________________________
Other: ___________________________________
Email Address: _____________________________________________________________________________________
Veterinarian: ________________________________________
Vet Phone #: _____________________________
Veterinarian’s Address: _______________________________________________________________________________
_________________________________________________________________________________________________
ABOUT THE RESCUE CAT’S NEW HOME:
1.
Is this rescue cat specifically for your household?
□ Yes □ No
NOTE: If this cat is not for your specific household, please have a responsible adult from the household where the
cat will live fill out this application.
2.
YOUR HOUSEHOLD: # of adults: ___________
3.
Does anyone in your household have allergies to animals? □Yes □No
If yes please describe: ________________________________________________________________________
4.
DO YOU: □ Own □ Rent
©2015, Every Life Matters Cat Rescue Inc. All rights reserved.
# of children & ages: ____________________________
If you rent, are cats permitted in the rental unit?
□ Yes □ No
July 2, 2015
Every Life Matters (ELM) Cat Rescue Inc.
Adoption Questionnaire
OTHER PETS & PREVIOUS PETS
1. Is this your first cat/kitten?
□ Yes □ No
2. Is this cat still a family member? __________________________________________________________________
3. If you currently have other pets, what are they, and their ages? ___________________________________________
4. Are they current on vaccinations?
□ Yes □ No
5. Are they spayed or neutered?
□ Yes □ No
6. Have you ever given up a pet for any reason to an organization or individual?
□ Yes □ No
7. If yes, please explain the circumstances for your decision: ______________________________________________
__________________________________________________________________________________________
RESCUE CAT’S FUTURE:
1. Do you have a space to isolate the new rescue cat for a week or so while s/he becomes familiar with you & your
home? □ Yes □ No Please describe the area: ____________________________________________________
2. Will your new rescue cat be kept inside?
□ Yes □ No
RESCUE CAT’S HEALTH:
1. Most rescued cats have unknown medical backgrounds. For this reason:
a.
Do you agree to take your new rescue cat to a licensed veterinarian for a complete veterinary exam within 7
business days after the adoption?
□ Yes □ No
b. Once the exam has been completed, if your new rescue cat becomes sick, you have the option to have the cat
treated at your own expense by a licensed veterinarian or return the rescue cat to Every Life Matters Cat
Rescue.
2. If you are interested in adopting a rescue kitten, do you agree to have him or her spayed or neutered by a licensed
veterinarian (or our authorized shelter veterinarian) on or before they turn six (6) months of age? □ Yes □ No
The fees for our rescue cats are as follows: Unfixed Kitten (1st set of shots only) - $80, Unfixed Kitten (2nd set of shots) $120, Fixed Kitten (6+ months) - $150, Fixed Adult Cat - $150, Senior Cat (10+ years) - $80. Adoption fee is payable upon
transfer of the adopted kitten/cat. Payments are accepted via Electronic Money Transfer (EMT) or Cash. Deferred payments
or partial payments are not accepted.
I certify that the above information is true and that false information may result in nullifying this adoption.
Applicant's Signature: _________________________________________
Date:____________________________
Every Life Matters Cat Rescue accepts your typed name as an e-signature and is legal and binding.
©2015, Every Life Matters Cat Rescue Inc. All rights reserved.
July 2, 2015
Every Life Matters (ELM) Cat Rescue Inc.
Adoption Questionnaire
Please fill out completely and email to Every Life Matters Cat Rescue.
©2015, Every Life Matters Cat Rescue Inc. All rights reserved.
July 2, 2015