Feline Surrender Request

The Humane Society at Lakewood Ranch is a 501(c)3 non-profit, no-kill animal rescue and shelter, that provides assistance and care for at-risk animals until forever homes can be found.

Our hope is to help keep owners and pets together through counseling and assistance.  if surrender is your only remaining option, our shelter manager will review the behavior and medical information provided.  If we believe we can accommodate your surrender request, we will contact you within one week to schedule an appointment to meet and evaluate your pet in person.

Please contact us at least 24 hours proir to your scheduled appointment should you need to cancel or reschedule.  An appointment does not guarantee acceptance into our adoption program.  If your pet is not a candidate  for our adoption program and we cannot accommodate your surrrender request, you will be notified within one week of receipt of your request.

Animal Information
Spayed/Neutered:
Front Declawed:
Back Declawed:
Animal Name:
Breed:
Age:
Color:
Weight:
Microchipped?:
Microchip Provider:
Microchip #:
Where did you acquire this cat?:
How long has this cat lived with you?:
Reason for surrender:
Owner Information
Full Name:
Street Address:
City:
State:
Zip:
Email:
Phone:
Medical History
Has your cat visited a veterinarian?:
If yes, date of last visit:
If yes, who is your veterinarian?:
Does your cat have any medical problems?:
If yes, please explain:
Is your cat on any medications?:
If yes, please list medications:
Behavior
Where does your cat spend most of his/her time?:
Does your cat enjoy (check all that apply)
Interacting with other cats:
Sitting on your lap:
Looking out the window:
Playing:
What toys does your cat prefer:
What does your cat do when confronted with an uncomfortable situation?
Runaway:
Hiss:
Swat:
Scratch:
Bite:
Has your cat ever done the following to a person?
Scratched:
Growled:
Nipped (Did not break skin):
Bit (Broken skin):
If yes, please explain:
How does your cat respond to the following:
Being picked up:
Being Held:
Head Scratched:
Chin Scratched:
Neck Scratched:
Belly Touched:
Base of Tail Touched:
Being Brushed:
Check all that describe your cat's personality:
Friendly:
Shy:
Independent:
Fearful:
Playful:
Affectionate :
Vocal:
Confident:
Gentle:
Active:
Quiet:
Curious:
What other animals has this cat lived with?
Small Dogs :
Medium Dogs:
Big Dogs:
Cats:
Other:
How does your cat get along with the following:
Dogs:
Cats:
How does your cat react to the following:
New People:
Groups of People:
Small Children:
Loud Noises:
Cat Carriers:
Trips to the Vet:
Litter Box Use
What type of litter box do you have?:
How many litter boxes do you have?:
Where are your litter boxes located?:
What type of litter do you use?:
Does your cat ever eliminate outside of the litter box?:
If Yes, do they:
If yes, where?:
If yes, how frequently?:
How long has your cat been inappropriately eliminating outside of the litter box?:
What have you done to try to correct the situation and for how long?:
Feeding Schedule
How often does your cat eat:
Dry Food:
Wet Food:
Is your cat on a special diet?:
If yes, what is the special diet?:
If I could change one thing about my cat it would be:
I would keep my cat if:
What kind of home do you think would be best for your cat?: