Cat Intake Form

CLIENT INFORMATION

Cat Owner Name:*

Your Phone:*

Your email:*

Your Address:*

Apt./Suite/etc.

Your City:*

Your Zip Code:*

Name of Second Pet Guardian:

Second Guardian phone:

Anyone else authorized to pick up your cat?*

How did you hear about us?*

EMERGENCY CONTACT INFORMATION

Veterinarian or Veterinary Clinic Name:*

Veterinarian Phone:*

ABOUT YOUR FELINE FAMILY MEMBER

Cats Name:*

Breed/Description *

Gender*

Male

Female

Spayed/Neutered*

Yes

Color:*

Approximate Weight*

Approximate Age:*

FEEDING INFORMATION

What brand and type of food is your cat fed?*

Cups per meal?*

Meals per day?*

Does he/she eat immediately or "Graze" all day?*

Grazes all day

Easts on Schedule

Any food allergies?*

Reaction to food allergies?*

Food Aggression?*

Yes

MEDICAL INFORMATION

Any medications your cat is on, dosage, frequency, and methods of taking?*

Any medications your cat is on, dosage, frequency, and methods of taking?(1)*

Has your cat been seen by his/her veterinarian in the past 6 months for anything? beyond wellness visits and vaccines?*

Rabies Expiration Date:*

FVRCP Expiration Date:*

FELV Expiration Date:*

Please provide a member of the staff with a copy or picture of their most recent vaccinations for our records. FLEA PREVENTION (if any), BRAND, AND LAST DOSE GIVEN: (PDF and Word Document ONLY)

FLEA PREVENTION (if any), BRAND, AND LAST DOSE GIVEN:

Your cat cannot be boarded without current immunizations; Rabies. (Cats exempt from immunization must have a written statement from veterinarian.)

Fvrcp & Felv mandatory.

VISITORS MUST have had a (snap test) for FIV and FeLV within the past 6

Please be advised that while we require up-to-date vaccinations, your cat may still get sick even if it has been vaccinated!

BEHAVIORAL INFORMATION

If bringing multiple cats can they sleep together/suite share?

Yes

Can they eat together?

Yes

If your cat does not eat well may we add something to entice eating?*

Yes

Has your cat ever bitten a person or other animal?*

Yes

My cat has permission to play with other cats and I understand the risks associated with such playtime.*

Yes

Any fears we should be aware of? Anxiety/fearful? Afraid of thunder/loud noises?*

Is your cat Possessive/resource guard? Have separation issues, etc.? *

Any other information/habits/behaviors you’d like us to be aware about?*

CERTIFICATION - PLEASE FILL IN YOUR NAME AND CAT(S) NAME(S)

I, CERTIFY THAT MY CAT(S), IS/ARE IN GOOD HEALTH, HAVE NOT BEEN ILL WITH ANY COMMUNICABLE DISEASES OR PARASITES IN THE LAST 30 DAYS, AND HAVE NOT HARMED OR SHOWN AGGRESSIVE OR THREATENING BEHAVIOR TOWARDS ANY PERSON OR ANY OTHER CAT.

Your Full Name*

Your Cat's Name:*

BY SIGNING BELOW, in consideration of the services rendered by All About Cats to my cat(s), I acknowledge reading, understanding, and accepting the statements herein.I understand certain “activities” that my cat may participate in, including daycare, boarding, and one-on-one play, may contribute to the following:

Exposure to parasites, viruses, and other medical conditions passed from cat-to-cat or person-to-cat;
Sprains, strains, bites, broken bones;
Fatigue, dehydration, nicks, cuts, or death.

I further understand that not each and every potential risk can be listed above but, nonetheless agree that the benefits associated with cat socialization outweigh the possible risks, therefore, I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify All About Cats and its agents, successors, heirs, from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my cat’s participation in activities at All About Cats, including those allegedly attributable to the negligent acts or omissions of All About Cats or their staff.

I understand that I may be exposed to certain risks when bringing my cat to participate in activities at All About Cats or when picking up my cat from participating in activities at All About Cats. Such risks may include property damage and/or physical injury inside or outside the facility, such as from falling, slipping, illness, and/or cat bites. Therefore, I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify All About Cats, its agents, successors, heirs from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my cat’s participation in activities at All About Cats, including those allegedly attributable to the negligent acts or omissions of All About Cats or their staff.

AUTHORIZATION FOR MEDICAL CARE

If my cat becomes ill or injured while participating in activities at All About Cats, All About Cats will make every reasonable effort to reach me pursuant to the contact information I have provided All About Cats. However, if All About Cats is unable to reach me, I consent to All About Cats seeking appropriate veterinary care and I accept responsibility for any and all associated expenses. All About Cats will not pay any portion of veterinary expenses associated with seeking medical care for my cat if so necessary.*

AGGRESSIVE BEHAVIOR

I affirm that I am not aware of any vicious tendencies by my cat. I represent that my cat is sociable and has not harmed or shown threatening behaviors towards any person or any other cat. I understand All About Cats reserves the right to remove my cat from the play area and place my cat in a separate holding area if my cat displays any unwanted behaviors. I also understand that All About Cats reserves the right to permanently remove a cat from its daycare or boarding facilities at anytime.*

VACCINATIONS AND PARASITE PREVENTION

I understand that - while my cat is fully vaccinated - vaccines are not guaranteed and there is a small risk that my cat may contract a contagious disease or illness. I agree that should this occur I am responsible for my own pet’s care and medical attention. I agree to allow 7 days waiting period after my cat has had their vaccinations to allow the vaccinations to reach full protection potential and to ensure my cat has not had any negative reaction to the vaccines. Should I allow my cat to stay at All About Cats less than 7 days after vaccination i understand that my cat could be at risk of contracting a contagious virus/disease. All pets staying within All About Cats must be free of external and internal parasites. Any pets found to have parasites will be immediately treated with an anti-parasitic medication at additional expense to the owner.

CRATE USAGE

I authorize my cat(s) to be placed in a crate during Boarding in the event the need were to arise.

LATE PICK UP/CHECK OUT FEES

I understand that All About Cats must adhere to safety regulations which limit the number of cats at our facility at any given time. As a result, it’s extremely important that cats being boarded must be picked up by the appointed pick up/check out times. Extended pick up/check out times may be coordinated on a case-by-case basis. However, if I have not coordinated an approved late pick up/check out time from All About Cats in advance, I agree to pay the late fees.

I AFFIRM that I have thoroughly read, fully understand, and voluntarily accept all of the terms, duties, and obligations set forth above. I also affirm that I am a guardian and owner of the pet(s) referenced in this form and I am responsible for any decisions made regarding my cat/ I am signing this of my own free will and have not been pressured to do so.

I am a legal adult (age 18 or older) and declare under penalty of perjury that the foregoing is true and correct and attest that the legal name and signature, details provided about my pet (if applicable), and contact information below is my own and I am signing this document for the purposes stated herein

Your (electronic) Signature:*

Date:*

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Cat Intake Form

Cat Sitting and Boarding Intake Form