Cat Intake Questionnaire

Leave this field empty

Date

Name*

First

Last

Phone*

Email

Address*

Street Address

Address Line 2

City

State

ZIP Code

Select One:*

StrayOwner Surrender

How many cats/kittens are you surrendering?*

Cats's Name and Gender (If more than one, please list all.)

Approximate Age:

Please select all that apply:

Spayed/NeuteredMicrochippedDeclawed

Reason for surrender? (Please explain.)*

How long have you been caring for this cat?*

Where did you acquire this cat?*

Has this cat been seen by a veterinarian?

YesNo

Veterinarian's Name:

Please list and explain any health issues we need to be aware of:

Does this cat use their litter box? If no, please explain.

Where does this cat primarily live?

IndoorsOutdoorsIndoor/Outdoor

Please select all that apply:

Good with childrenGood with dogsGood with other catsPrefers to be an only petUnknown (stray)

Please select all that apply (personality):

Lap catPrefers to be alonePlayfulShy or nervous

What else would you like for us to know about this cat?

* Required field

Our Mission

Dedicated to promoting the compassionate treatment of animals in our community through adoption, public spay/neuter services, sheltering and education.

Phone: 912.264.6246 | Fax: 912.264.2156
Hours of Operation: Tuesday – Saturday 11 am – 4 pm. Adoptions stop at 3:30 pm.
4627 US HWY 17 North | Brunswick, Georgia 31525

HSSCG is a recognized 501(c)3.
Federal ID Number: 58-6073265
Email: [email protected]

HSSCG
The Big Flea
Friends of HSSCG

A no-kill, 100% donor-funded animal shelter serving South Coastal Georgia.

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