Adopt a Cat Adoption Interest Survey Adopt a Cat Adoption Interest Survey Complete this Interest Survey if you would like to adopt a cat. Thank you so much for your willingness to open your home to a rescued cat or kitten from SAFE Haven for Cats! After your Adoption Interest Survey is submitted, you may also get a call from one of our adoption counselors to discuss your thoughts about your new (cat) family member. Note that fields marked with a * are required.Your Information:Your Name* First Last Are you 21 or older?*YesNo Applicants must be 21 years old or older to adopt a cat from SAFE Haven. Please do not continue with the adoption form.Cat Preferences and Expectations:What age cats are you interested in adopting? Check all you would consider.* Adult Cat (1 year or older) Teenage Cat (6 months - 1 year) Kitten (3 months - 6 months) Mature Cat (5 years or older) Special Needs Cat What is your cat gender preference?*MaleFemaleNo PreferenceWill this be your first cat?*YesNoHow long do you expect it to take your new cat to adjust to its new home?*1-2 daysAbout 1 week2-3 weeksA month or moreCurrent Pets:Do you currently own pets?*YesNoWhat type(s) of pets?* Cat Dog Other Tell us about your cat(s):How many cats do you have?*Select1 cat2 cats3 cats4 cats5 cats6 catsMore than 6 catsIf over 6 cats, how many in total?*Cat #1:NameAge*Is this cat sterilized?*YesNoIs this cat declawed?*YesNoWhere does this cat stay?*Inside OnlyInside and OutsideOutside OnlyCat #2:NameAge*Is this cat sterilized?*YesNoIs this cat declawed?*YesNoWhere does this cat stay?*Inside OnlyInside and OutsideOutside OnlyCat #3:NameAge*Is this cat sterilized?*YesNoIs this cat declawed?*YesNoWhere does this cat stay?*Inside OnlyInside and OutsideOutside OnlyCat #4:NameAge*Is this cat sterilized?*YesNoIs this cat declawed?*YesNoWhere does this cat stay?*Inside OnlyInside and OutsideOutside OnlyCat #5:NameAge*Is this cat sterilized?*YesNoIs this cat declawed?*YesNoWhere does this cat stay?*Inside OnlyInside and OutsideOutside OnlyCat #6:NameAge*Is this cat sterilized?*YesNoIs this cat declawed?*YesNoWhere does this cat stay?*Inside OnlyInside and OutsideOutside OnlyTell us about your dog(s):How many dogs do you have?*Select1 dog2 dogs3 dogs4 dogs5 dogsMore than 5 dogsIf over 5 dogs, how many in total?*Dog #1:NameAge*Is this dog sterilized?*YesNoWhere does this dog stay?*Inside OnlyInside and OutsideOutside OnlyDog #2:NameAge*Is this dog sterilized?*YesNoWhere does this dog stay?*Inside OnlyInside and OutsideOutside OnlyDog #3:NameAge*Is this dog sterilized?*YesNoWhere does this dog stay?*Inside OnlyInside and OutsideOutside OnlyDog #4:NameAge*Is this dog sterilized?*YesNoWhere does this dog stay?*Inside OnlyInside and OutsideOutside OnlyDog #5:NameAge*Is this dog sterilized?*YesNoWhere does this dog stay?*Inside OnlyInside or OutsideOutside OnlyTell us about your other pet(s):How many other pets do you have?*Select1 other pet2 other petsMore than 2 other petsIf over 2 other pets, how many in total?*Other Pet #1:Type / Breed*Age*Is this pet sterilized?*YesNoWhere does this pet stay?*Inside OnlyInside and OutsideOutside OnlyOther Pet #2:Type / Breed*Age*Is this pet sterilized?*YesNoWhere does this pet stay?*Inside OnlyInside and OutsideOutside OnlyPast Pets:Have you previously owned any pets in the last 5 years?*YesNoPlease list these pets and describe what happened to them.*Household Information:Household member(s):How many household members including yourself?*SelectOne (just myself)Two membersThree membersFour membersMore than four membersIf over 4 household members, how many in total?*Yourself (Member #1):Relationship*Your Age*Household Member #2:Name* First Last Relationship*Age*Household Member #3:Name* First Last Relationship*Age*Household Member #4:Name* First Last Relationship*Age*Are there any young children in your household?*YesNoWhat steps would you take to protect both a young child and the pet?*Please select your home type*Single Family HomeTownhouse or CondoApartmentMobile HomeAre you employed?*YesNoName of your employer*Is your spouse or partner employed?*YesNoNot ApplicableName of your spouse or partner employer*When home alone where will the cat stay?*GarageBasementOutdoorsOne roomWill have run of the houseOtherOther place(s) the cat will stay*Do you have a pet door?*YesNoWhen will the cat be allowed outside? Check all that apply.* When I am home On a leash only On a deck or patio Never In a fenced yard In a screened porch When the cat wants to be Out during the day only/in at night Discussion topics for your Adoption Counselor:Please select the topics you would like to discuss in detail:* Litterboxes Feeding Grooming Nail trimming (demo provided) Biting Scratching (people) Scratching (furniture) Safe outdoor experiences Spraying Vaccinations Fleas/Worms Microchipping Introduction to resident cat Introduction to resident dog Adjustment to new home Kids & cats Allergies Kitten vs. Adult (better for my situation) Other topics List other discussion topics hereDo you plan to declaw your cat?*YesNoNot sure, I need more informationWhy do you plan to declaw your cat?*How did you hear about SAFE Haven Cat for Cats? Select all that apply.* Google Search Friend/Family WRAL Pet of the Day Previous Adopter Facebook Instagram SAFE Haven Event Volunteer Petfinder.com TV/Radio Veterinarian Prefer not to say Other Ways Other ways you heard about SAFE Haven for Cats*Any additional comments or questions?Completion of this application means you are 21 years or older. These statements would become part of a written contract if you adopt from SAFE Haven.Your Full Name (Digital Signature)*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home or Mobile Phone Number*Work Phone NumberEmail Address* Email Confirm Email Featured Cat NoelleFemale - Teenager Upcoming Events There are no upcoming events at this time.