OWNER'S First Name *

OWNER'S Last Name *

Email Address *

Phone Number (Mobile Preferred) *

Confirm Email Address *

Confirm Phone Number *

Address *

City *

Postal code *

____________________

Do you have a Pet Promise Agreement from the Niagara SPCA? *

Found in adoption folder

YES - Niagara SPCA
YES - Fort Erie SPCA
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If adopted, your pet's Animal ID (found on front of adoption folder) *

Cat's Name *

Cat's Date of Birth (including YEAR) *

Sex *

Male
Female
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Breed *

Colour *

Cat's Weight (lbs):

Does your pet have a regular veterinarian? *

YES

Regular Veterinarian's Name

Clinic Name and Address

____________________

Please review the following questions regarding your pet's health carefully. Submitting incorrect or incomplete information will delay your appointment booking.

Are both testicles descended (looks/feels like two lumps in the scrotum)? *

Yes - both testicles have descended

No - one or both testicles have not descended

N/A - female cat

Does your pet have a hernia? (Please note, do we not offer hernia repairs for male cats) *

Yes - my pet has a hernia
No - my pet does not have a hernia
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Does your pet have any health concerns (past, present or chronic)? *

Is your pet taking any medication? *

Is your pet an ideal body condition based on the chart below? *

Yes - my pet is an ideal body condition
No - my pet is underweight
No - my pet is overweight/obese
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Is there a possibility of pregnancy? *

Yes
No
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Questions and Comments

Ownership Declaration *

I declare ownership and responsibility of the animal listed on this form. All forms, certificates and communication will be addressed to me at the ownership information I provided above. I declare that I am of legal age in the province of Ontario (18).

If you hit Submit and the page does not change, there is information missing.

Please scroll up through the form to find any fields in RED.