Cat Owner Surrender Form

Full Name

Email

Telephone Number

Address, Town, County

Name

Age

Gender

Colour

Long haired / Short haired?

How long do you have your cat

Has your cat been neutered? Yes No

Is your cat up to date with vaccinations? Yes No

Is your cat microchipped? Yes No

Has your cat had any illness, injuries, undergone any surgery or any insurance claims made after you adopted him/her from the DSPCA? If Yes, give full details below

When was your cat last visit to the vet?

Is your cat good with other cats? Yes No

Did your cat live in a home with children? Yes No

If yes, please give ages of children

Did your cat live inside your home? Yes No

Where did your cat sleep at night?

Please write down the reason why you are surrending your cat to the DSPCA. Please be completely honest with the details you are providing us. It will help us find the right cat home for your cat.

I understand that is a big decision to surrender my pet to the DSPCA. I confirm that I have discussed all options in regards to what I can do to prevent having to surrender my pet to the DSPCA for rehoming but have decided to do so. I understand that by signing this form I relinquish my ownership of this animal. I understand that this animal is now the property of the DSPCA.

I agree that all the information I have provided above is true and correct.