Cat History Form - Ottawa Humane Society

Owner Information

You need to surrender your pet to the OHS because: *

Moving and unable to bring pet (please provide moving date below)
Cost of having a pet
Pet is injured/ill (please provide more information below)
Pet is aggressive
Behaviour issue
Too many animals
Not enough time
Pet is house soiling
Other (please provide more information below)
Prefer not to say

Are you surrendering your pet for end of life care (humane euthanasia)? *

Yes
No

Please share your moving date. *

Please share details of your pet's injury or illness. *

Please share your reason for needing to surrender your pet to the OHS. *

Your Name *

First Last

Email *

Phone Number *

Address *

City *

Province *

Postal Code *

Information About Your Pet

Name *

Age *

Gender (or litter of kittens) *

How many kittens are in the litter? *

Do you know of any past or current medical conditions? If yes, what are they? *

Is your pet currently on medication? If yes, please specify. *

Is your pet currently on a special diet? If yes, please specify. *

What is the name of your pet's veterinarian?

Your Pet's History

How long have you owned your pet? (Number of years, months, etc.) *

How did you acquire your pet? *

Ottawa Humane Society
Found them outside
Pet Store
Friend or relative
Online
Placement Group
An animal shelter that wasn't the Ottawa Humane Society
Breeder

Please share the name of the animal shelter, placement group or breeder. *

You live in the: *

City (urban area)
Suburbs
Country

Are there other pets in your home? *

Yes
No

What types of pets do you own? *

Cats
Dogs
Rabbits
Other

Please specify: *

Do you let your cat outdoors? *

No
Sometimes
Harness only
On a balcony
Supervised
In a secure yard
In an enclosure
Free to roam

What do you feed your cat? *

Dry food
Wet/Canned food
Both

How many times do you feed your cat each day? *

Once (1)
Twice (2)
Three times (3)
Food is always available

Your cat's appetite is: *

What is your cat's favourite treat? *

What does your cat scratch? *

Scratching posts
Soft furnishings (sofa, drapes, etc.)
Carpets/rugs
Wooden furniture
Nothing
Other

Select all behaviours your cat has shown. *

Are there any other behaviours we should know about?

Does your cat have access to a litter box in the house? *

Yes
No

What type of litter do you use? *

How many litter boxes are in your home and where do you keep them? *

Is your cat's litter box covered or open? *

Covered
Open

What size is your cat's litter box? *

If you have multiple cats, do they share a litter box? *

Yes
No
N/A

How often do you clean your cat's litter? *

Daily
Twice a week
Once a week
N/A

Is your cat: *

Very clean
Clean
Messy

Has your cat ever failed to use their litter box? *

Yes
No

When did your cat start failing to use the litter box (approximate date)? *

Did you change the brand or type of litter in the past few months? *

Yes
No

Please describe the accidents. *

Select All
Urinates outside the box
Urinates on clothing/furniture
Defecates outside the box
Sprays on walls/furniture

How often does your cat fail to use the litter box? *

Rarely
Two (2) to three (3) times a month
Weekly
Two (2) to three (3) times a week
Daily

Do the accidents happen at the same time of day? *

Yes
No

Do you know why your cats is having troubles using their litter box? (New baby, moving, schedule changes, etc.) *

Were you able to correct the problem? If so, what did you do? *

Did your veterinarian rule out medical reasons as the cause of the problem? *

Yes
No

Your Pet's Behaviour

Has your cat ever bitten a person? *

Yes
Yes, and the bite broke the skin
No
Don't know

What caused the bite? *

Is your cat vocal with you? *

Is your cat vocal with other cats in the home? *

Is your cat vocal when they are alone? *

Is your cat fearful with you? *

Is your cat fearful at the veterinarians'? *

Is your cat fearful when people visit? *

Is your cat fearful of loud noises (vacuum cleaner, etc.)? *

Is your cat fearful of other cats? *

Is your cat fearful of dogs? *

Is your cat fearful with children? *

Is your cat friendly with you? *

Is your cat friendly with strangers? *

Is your cat friendly with children? *

Is your cat friendly with other cats? *

Is your cat friendly with dogs? *

Is your cat aggressive when you pick them up? *

Is your cat aggressive when you pet them? *

Is your cat aggressive when you groom them? *

Is your cat aggressive with the veterinarian? *

Is your cat aggressive towards other cats at home? *

Is your cat aggressive towards other cats outdoors? *

Is your cat aggressive towards dogs? *

Does your cat like to sleep with you? *

Does your cat like to be petted? *

Does your cat like to be around you? *

Is your cat active and intense? *

Is your cat patient and relaxed? *

I understand that some animals have medical or behaviour issues that make them difficult or impossible to rehome, and the OHS will not adopt out any animal believed to be a public safety risk. Additionally, some animals become highly stressed in a shelter environment, which makes them more susceptible to illness and, despite aggressive veterinary treatment, unlikely to recover from such illness. The OHS will not keep an animal in a state of suffering when their prognosis is poor or when the OHS lacks the resources to restore the animal’s health. I understand that these animals will be humanely euthanized by caring, professional staff. The OHS does not humanely euthanize healthy, adoptable animals regardless of length of stay or lack of space. *

I agree

I understand that I will need to provide proof of ownership for the animal being surrendered, such as City of Ottawa registration, a bill of sale, a receipt from my veterinary clinic, or photos. *

I agree

I understand that I will need to provide a piece of photo identification for myself at the surrender appointment. *

I agree

If possible, please provide your pet's veterinary records.

Accepted file types: pdf, Max. file size: 8 MB.

If possible, please provide a photo of your pet. (JPEG format)

Accepted file types: jpg, Max. file size: 8 MB.

Is there anything else we should know about your cat?