RSPCA Darwin Regional Branch

Cats and Kittens - RSPCA Darwin Regional Branch

RSPCA NT

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Cats and Kittens

Animal Surrender Application - Cats and Kittens

Step 1 of 10 - Your Details

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Comments
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Your Details
Title*
First name*
Last name*
Address*
Suburb*
State*
Postcode*
Phone number*
Email address*
Date of birth*
DD slash MM slash YYYY
Drivers license no*
Photo ID*
Accepted file types: jpg, gif, png, Max. file size: 40 MB.

Please upload a photo of the front/ back of your driver's licence, 18+ card or passport
Secondary Contact Name*
Secondary Contact Number*

Your Cat's Details
Cat's Name*
Age*
Breed*
Gender*
Desexed*
Microchipped*
Microchip number*
Where did you get your cat?*
How old was the cat when you acquired them?*
What is the main reason for surrender?*
Example; you cannot afford vet treatment
Is the above the only reason you're looking at surrender?*
Is there anything that would help you keep your cat?*
If you selected yes, please detail*

Medical Information
When did your cat last visit a vet?*
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Does your cat have ANY signs of illness/injury that concern you?*
Example: diarrhoea, lost appetite, etc.
If yes, what are the signs? Please provide as much detail as possible*
Example: how long have they been present, are they getting better or worse, have you sought vet advice?
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Is your cat on any medication?*
If yes, please provide details*
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Does your cat have, or has ever been diagnosed (by a vet) with a medical condition?*
If yes, please provide details*
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Please list every vet practice your cat has been taken to. By submitting this application, you are consenting to RSPCA requesting the cat's medical history*

Lifestyle & Home Life
Is you cat allowed indoors, outdoors or both?*
Where does your cat prefer to spend most of its time?*
When noone is home where is your cat kept?*
Where does your cat sleep at night?*
How many hours does your cat spend on their own each day?*
Does your cat like to keep you company when you are home?*
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Does your cat use a litter tray?*
How many trays does your cat have access to?*
Are the litter trays?*
If other, please detail*
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What type of litter does your cat prefer?*
Has your cat ever urinated elsewhere in the house?*
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1a. If yes, how often and where?*
1b. If yes, is it usually in the same spot or always somewhere else?*
Has your cat ever defecated elsewhere in the house?*
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2a. If yes, how often and where?*
2b. If yes, is it usually in the same spot or always somewhere else?*
When did your cat start to urinate/ defecate inappropriately?
Did anything change at the time the urination/ defecation outside of the litter tray began?
Example: something big like a new pet in the home, or small like furniture being rearranged. Please provide as much detail as possible
What, if anything, have you tried to do to rectify this behaviour?

Behaviour & Temperament
How active is your cat?*
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Has your cat ever lived with dogs?*
If yes, please describe how they interact*
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Has your cat ever lived with other cats?*
If yes, please describe how many and how they interact*
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Has your cat lived with any other pets not listed above*
If yes, please detail*

Social Interactions
How would you describe your household?*
How many adults (over 18) live in your household?*
How many children live in your household? Please include ages*
Do children interact with the cat?*
If yes, please describe interactions*
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When playing with children, does the cat play too rough?*
Describe any unpleasant situations with
Children*
Adults*
Animals*

Reactions
Please describe how your cat interacts with visitors/ strangers?*
Is your cat happy to be petted by visitors/ strangers?*
If no, how does your cat react?*
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Does your cat like to be picked up and handled by familiar people?*
If no, how does your cat react?*
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Does your cat like to be patted by familiar people?*
If no, how does your cat react?*
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Does your cat like to hunt/ chase prey?*
Is your cat shy and likes to spend most of its time alone?*
How affectionate is your cat?*
Has your cat ever scratched anyone?*
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If yes, please describe the circumstances*
If yes, did the scratch draw blood?*
Has your cat ever bitten anyone?*
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If yes, please describe the circumstances*
If yes, did the bite draw blood?*
Does your cat show aggressive behaviours/ lash out at anytime when NOT being interacted with by humans?*
Example: jump out from behind a door at someone walking past and bite/scratch, run down the hallway after you and bite/scratch, approach a child from behind and bite/scratch unprovoked
Has your cat had any fights with other cats*
If yes, please describe*
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Does your cat show any of the following behaviours?*
- Scratch furniture
- Jumping up on counters
- Chew plants
- Chew electric cords
- Climbing curtains
- Spraying
- Escaping – breaking through screens to get out

Grooming
How often do you brush your cat?*
How does your cat behave when groomed?*
Food and Feeding
How many times a day is your cat fed?*
What type and brand of food does your cat have. Are they a fussy eater?*
Example: wet/ dry food

Owner's Assessment of a Suitable Environment and Family for Their Cat
Please indicate whether or not you think the following living arrangements would likely suit your cat
Living with children, please specify age range*
- Children aged 0-8 years
- Children aged 9-15 years
- Children aged 16-18 years
- Noone under 18 years
Living with dogs*
Living with cats*
Living in a unit or exclusively indoor home*
Living with an elderly or frail person/ couple*
Living in suburbia*
Living on acreage*
Does your cat have any habits you do not like?*
What is your favourite thing about your cat?*
With your knowledge of this cat, do you believe they are behaviourally sound and physically healthy*
Do you feel that your cat will cope with being housed in a busy shelter environment?*
Any other comments or information that would be useful for us or a new owner to know?
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DECLARATION*
- As the sole legal and beneficial owner of the animal described above, I declare that: 1. I surrender as the sole legal and beneficial owner, the animal free of any third party; 2. I surrender all my rights, titles and interest in the animal to RSPCA Darwin and in doing so I understand that the animal will become the sole and absolute property of RSPCA Darwin; 3. I agree to indemnify RSPCA Darwin and keep RSPCA Darwin so indemnified against all claims (if any), costs and expenses whatsoever arising out of any action by any person claiming an interest in the animal; 4. I am 18 years of age or older.
- The animal is not owned by me, I am not aware of the animal’s true owner and I have made all reasonable efforts to identify the owner, therefore I believe the animal to be a stray.
- The animal has been abandoned by a third party on a property owned/controlled by me
IMPORTANT INFORMATION - PLEASE READ CAREFULLY

By completing and signing this form, you are surrendering legal ownership of the animal described above to RSPCA Darwin once the animal is in care. RSPCA Darwin reserve the right to rehome the animal at their own discretion. You also acknowledge that you are not entitled to updates on the animals condition or whereabouts at any time

You also confirm that you have read and understood the surrender information above

Once contacted by RSPCA Darwin you will have 48 hours to bring the animal into RSPCA Darwin's care if approved.

A surrender fee applies. The Shelter Supervisor will be in contact to discuss further when application is approved for intake.
Owners name*
Date*
DD slash MM slash YYYY
Please upload a picture of your cat
Accepted file types: jpg, gif, png, Max. file size: 40 MB.
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