Adoption Questionnaire

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Japan Cat Network
Adoption Questionnaire

Date:

Personal Information

Name:
Address:
Home Phone:
Mobile Phone:
PC Email:
Mobile Phone Email:
Workplace or Company Name:
Work Phone:
Nearest Train Station:

Alternative Contact Person / Reference

Name:
Relationship:
Phone Number:
Email:

How did you come to know about Japan Cat Network?

I would like to:
 Adopt a cat  Foster a cat  Undecided

Please explain the reason for your choice:

What kind of cat are you looking for?

Your Home

1. Who are you adopting this cat for?
 Self  Friend  Partner  Child  Our Family  Other ________________

2. How do other members of the household feel about getting a new cat?

3. Please list the members of your household that will live together with the new cat:
Name, Age, Occupation
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

For military families, please add; name of base, your organization (the squadron/unit)
and work phone number.
_____________________________________________________________________________
______________________________________________________________________________

4. Who will be mainly responsible for the care of the new cat?

5. Is anyone in your household allergic to cats?
 Yes  No

6. How busy is your family?
 Very  A little  Sometimes  Not at all  Other ________________

7. Typically, how long will the cat be left alone during the day?

8. What will happen to the cat during vacations and long weekends away?
 At Home, leaving out sufficient food/water
 At Home - a caregiver will visit to provide food/water
 At Home, with live-in pet-sitter
 Friend/Relative’s home
 Pet hotel/Boarding service
 I don’t know
 Other _________________

9. In the event of an emergency where you were temporarily unable to care for your cat, do you have someone you could call on to help you care for your pets?
 Yes  No

10. Where will your cat likely spend time?
 Indoors only  Outdoors only  Indoors/Outdoors
 Indoors & Balcony/Patio  Other ________________
Please explain the reason for your choice

11. Will your cat be going outside?
 Yes  No  Sometimes  Other _________________

12. Where do you live?
 House  Apartment/Mansion  Other _______________

13. My home is:
 Owned  Rented
If rented, does the housing contract allow pets?
 Yes  No

14. How long have you lived in your current home?

15. Do you plan to move any time in the near future?
 Yes  No  Not sure

16. If you make the decision to move, what do you plan to do with your pets?

17. For those without a Japanese passport, are you aware of the laws and regulations for bringing cats back to __________________________ ( please specify your home country)?
 Yes, definitely  Not at all  Somewhat aware

Please note that some countries have a long or strict quarantine including;
Hawaii, Guam, Australia, and New Zealand.

Your Pets

1. Do you currently have other pets?
 Yes  No
***If no, please skip to question 6.

2. Please list all pets that will live together with the new cat:

Type of animal Age  Male  Neutered
_______________________ _________  Female  Spayed
How long have you had him/her?
I got this pet from:
 Friend/relative’s pet that gave birth
 Breeder
 Pet store
 Rescue Group (SPCA, etc.)
 Off the streets as a stray
 Other _______________

Type of animal Age  Male  Neutered
_______________________ _________  Female  Spayed
How long have you had him/her?
I got this pet from:
 Friend/relative’s pet that gave birth
 Breeder
 Pet store
 Rescue Group (SPCA, etc.)
 Off the streets as a stray
 Other ______________

3. Where do you keep your current pets?
Indoors only Outdoors Only Indoors/Outdoors Cage
Cat    
Dog    
Other    

4. How do your pets behave towards cats?
 Friendly  Playful  Afraid  Aggressive  Not sure  Other _______________

5. Are all your pets up-to-date on their vaccinations?
 Yes  No

6. Have you ever had a pet at some point in the past (aside from any already listed above)?
 Yes  No

7. If yes, please describe your former pets :
Type of animal  Male  Neutered How long did you have this pet?
____________________  Female  Spayed ________________________
I got this pet from:
 Friend/relative’s pet that gave birth
 Breeder
 Pet store
 Rescue organization (SPCA, etc.)
 Off the streets as a stray
 Other _____________________
What happened to this pet?
 Died (please specify cause of death) ________________________
 Ran away/disappeared
 Found him/her a new home
 Surrendered to a rescue organization (SPCA, etc.)
 Other ______________

Type of animal  Male  Neutered How long did you have this pet?
_____________________  Female  Spayed ________________________
I got this pet from:
 Friend/relative’s pet that gave birth
 Breeder
 Pet store
 Rescue organization (SPCA, etc.)
 Off the streets as a stray
 Other _____________________
What happened to this pet?
 Died (please specify cause of death) ________________________
 Ran away/disappeared
 Found him/her a new home
 Surrendered to a rescue organization (SPCA, etc.)
 Other ______________

8. Do you have rules you will expect your new cat to follow? (eg. No jumping on counters, etc.)

9. What would you do if your cat begins to exhibit a behaviour you consider to be negative?

10. Under what conditions would you consider returning your cat? (please check all that apply)
 Aggression  Too expensive
 Scratching furniture  Moving
 Toileting issues  Not enough time
 Inability to get along with other pets  Sick cat
 Allergies  New baby
 Other ______________

11. What veterinary clinic will you be using?

12. Should your cat become ill or injured, are you willing and able to provide veterinary care?
 Yes  No  Depends on how expensive it is.

13. Are you planning to have your cat declawed?
 Yes  No  Undecided
Please explain the reason for your choice.

14. Will you send pictures and a short update on the cat’s progress to JCN, to be used in the newsletter and/or on the website?
 Yes  No

15. What do you think a cat needs to be happy?

16. What would you never do in regards to your pet cat?

17. Please describe one of your cat experiences:

Other comments or questions:

THANK YOU FOR COMPLETING THIS QUESTIONNAIRE.
THIS INFORMATION WILL ASSIST US IN MATCHING YOU WITH THE RIGHT CAT FOR YOUR FAMILY.

Japan Cat Network

Helping People Help Cats