Rehoming Support Inquiry Form

Pet Information

Type of Animal*

Dog
Cat
Critter

Dog Questionnaire

Pet's Name*

Breed*

Pet's Age*

Pet's Gender*

Pet's Approximate Birth Date*

Spayed/Neutered*

Yes
No

Microchipped*

Yes
No

Color(s)*

Last Vaccination Date*

Name of Regular Veterinarian

Has Your Pet Ever:

Growled
Snapped
Bitten a person

Please check all that apply.

If you checked any of the above, please describe the incident(s):

Please describe any bad habits or medical issues that a new owner should be aware of:

How long have you had this pet?*

To your knowledge, how many previous owners has this pet had?*

Where did you acquire them?*

Breeder
Friend/Relative
Found Stray
Born at Home
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The Humane Society for Tacoma & Pierce County
Other Rescue/Shelter

What kind of training has your pet had?*

Obedience Class
Home Training
Professional Training
None

Does your pet know how to:

Sit
Stay
Come
Lie Down
Walk on Leash
Other

Check all that apply.

Is your pet crate trained?*

Yes
No

If yes, how long can they comfortably stay in the crate:

Where do you leave your dog when they are alone?*

Check all that apply.

How many hours per day on average does your pet spend alone?*

Where does your dog sleep?*

Indoors unconfined
Indoors confined in crate/room
Outside
Garage or Basement

Check all that apply.

Is your dog housebroken?*

Yes
No

How do you know when your dog needs to go to the bathroom?

Please describe how often your pet eats, how much, and the brand of food given:*

Does your pet get along with other dogs?*

Yes
No

If no, what do they do around other dogs?

Does your pet get along with cats?*

Yes
No

If no, what do they do around cats?

My pet has lived with:

Other Dogs
Cats
Caged Animals
Livestock
Other

Check all that apply.

Has your dog ever killed or injured another animal?*

Yes
No

If yes, please explain:

My dog has:*

Lived with children
Regularly visited children
Has infrequent contact with children
No experience with children
Negative experience with children

Check all that apply.

If there has been a negative experience with children, please explain:

What are your dog’s BEST qualities?*

How would you describe your dog’s personality?*

What are your dog’s favorite activities?*

What would your dog’s ideal home be like?*

My pet's energy level is:*

Low
Average
High

How much exercise does your dog need regularly?*

Lots
Moderate
Little or none

Is your dog used to grooming?*

Yes
No
Unknown

If yes, who has groomed them? (i.e. yourself, grooming professional)

Are you able to trim your dog’s nails?*

Yes
No
Unknown

How do they react to nail trims?

Cat Questionnaire

Pet's Name*

Breed*

Pet's Age*

Pet's Gender*

Is your pet spayed/neutered?*

Yes
No

Is your pet microchipped?*

Yes
No

Is your pet declawed?*

Yes
No

Color(s)*

You have owned this animal since (approximate date):*

Was this cat adopted from The Humane Society for Tacoma & Pierce County?*

Yes
No

If not, from where did you obtain this cat?

Please list any bad habits or medical issues that a new owner should be aware of:

Current veterinarian/clinic:

Current veterinary clinic address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Current veterinary clinic telephone number:

How long has your pet been going to this veterinarian/clinic?

Has your pet ever bitten anyone?*

Yes
No

If yes, please explain:

My pet lives:*

Indoors only
Indoors at night
Indoors with access to outdoors
In a barn or shed
In a garage or basement
Other

Check all that apply.

How many hours per day on average does your cat spend alone?*

Where does your cat sleep?*

Indoors unconfined
Indoors confined in crate/room
Outside
Garage or basement
Other

Check all that apply.

Do you trust your cat indoors unsupervised?*

Yes
No

If no, please explain:

Is your cat litter box trained?*

Yes
No

If no, please explain:

Please identify any other bathroom habits your pet has:

Goes outdoors
Has occasional accidents
Frequent accidents
Sprays

Check all that apply.

Please identify the brand of cat litter your cat prefers:

How would you describe your household?*

Noisy
Active
Average
Quiet

Check all that apply.

Please explain the amount of food and brand of food provided at each sitting:*

My cat eats:*

Once in the morning
Once in the evening
Twice a day
Food left out always

Would you recommend that your cat be placed in a home with children?*

Yes, any ages of children
Yes, but only children older than a certain age
No

If yes, but only children older than a certain age, please provide the recommended age:

My cat has:*

Lived with children
Regularly visited children
Has infrequent contact with children
No experience with children
Negative experience with children

Check all that apply.

If lived with children or regularly visited children, please identify their age(s):

If negative experience with children, please identify their age(s):

Your pet's experience with cats:*

Positive
Negative
No experience

Check all that apply.

Your pet's experience with dogs:*

Positive
Negative
No experience

Check all that apply.

Your pet's experience with caged animals:*

Positive
Negative
No experience

Check all that apply.

Your pet's experience with livestock:*

Positive
Negative
No experience

Check all that apply.

Your pet's experience with other animals (not specified above):

Please explain any significant reaction:

What are your cat’s BEST qualities?*

Your cat enjoys:

Sleeping on lap
Playing with toys
Other

Check all that apply.

If other, please describe:

Your cat's favorite treats are?

Is your cat a good hunter?*

Yes
No

If yes, please explain:

Does your cat use a scratching post?*

Yes
No

If yes, what kind?

Has your cat been vaccinated in the last year?*

Yes
No

If yes, what vaccines?

Has your cat been tested for FIV & FeLV?*

Yes
No

If yes, what were the test results?

Positive
Negative

Has your cat been vaccinated for FIV & FeLV?*

Yes
No

Has your cat received flea treatment?*

Yes
No

If yes, what kind and when?

Please describe any current medical problems or medications:

Please attach all relevant medical and health records (including vaccination schedules and test results)

Max. file size: 100 MB.

What do you want your cat’s new owners to be like?*

Critter Questionnaire

Pet's Name*

Breed*

Pet's Age*

Pet's Gender*

Approximate birth date:*

How long have you owned this critter?*

Was your critter adopted from The Humane Society for Tacoma & Pierce County?*

Yes
No

If not, from where did you obtain your critter?

Does your critter have any bad habits or medical issues that should be known by the new owner?

Is your pet spayed/neutered?*

Yes
No

Is your pet tattooed?*

Yes
No

If yes, where?

Is your pet microchipped?*

Yes
No

If yes, please provide the microchip number:

Current veterinarian:

Current veterinary clinic:

Current veterinarian/clinic address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Current veterinarian/clinic telephone number:

How long has your pet been going to this veterinarian/clinic?

My critter lives:*

Indoors only
Indoors at night
Outdoor hutch
In garage or basement

Check all that apply.

How many hours per day on average does your critter have interaction with people?*

If applicable, is your critter litter box trained?

Yes
No

If no, please explain:

Please indicate any other bathroom habits your pet has:

Has occassional accidents
Frequent accidents
Sprays/marks territory

Check all that apply.

If applicable, please identify the brand of litter used:

How would you describe your household?*

Noisy
Active
Average
Quiet

Check all that apply.

My critter eats:*

Vegetables
Hay
Pellets

Check all that apply.

If they do eat vegetables, what kind?

My critter drinks from:*

Water bottle
Water dish

Check all that apply.

What's your critter's experience with children?*

Positive
Negative
No experience

If any experience with children, please specify ages:

What's your critter's experience with dogs?*

Positive
Negative
No experience

What's your critter's experience with cats?*

Positive
Negative
No experience

What's your critter's experience with caged animals?*

Positive
Negative
No experience

Please explain any negative reactions:

Your critter enjoys:

Interacting with people
Playing with toys
Exploring
Being held

Check all that apply.

How would you describe your critter’s personality?*

What type of home would your critter do best in?*

Anything else we should be aware of?