Cat Adoption Form

Cat Details

Enter details from the kennel paperwork

Identification

Shelter ID *

Required

Cat's Name *

Required

Microchip Number *

Required — check kennel paperwork

Date of Birth

Approximate Age

Description

Breed *

Required

Colour *

Required

Sex *

Required

Desexed

Package *

Required

Price

$

Please confirm cat’s price with the new owner.

Veterinary Dates

IMPORTANT: Please confirm these dates are correct and change if they are not. Please discuss the dates with the new owner.

Last Vaccination Date

Next Vaccination Due *

Required — discuss with new owner

Last Flea Treatment Date

Next Flea Treatment Due *

Required — discuss with new owner

Last Worming Date

Next Worming Due *

Required — discuss with new owner

Suture Removal Date (if applicable)

New Owner Details

Owner to complete their own contact information

Personal Details

Title

First Name *

Required

Surname *

Required

Address

Residential Address *

Required

Suburb *

Required

State *

Required

Postcode *

Required

Contact Details

Mobile *

Required

Home Phone

Email Address *

Valid email required

Alternate Contact

Alternate Contact Name

Alternate Contact Phone

Health & Microchip

Staff to complete this section — review kennel paperwork before proceeding

Health Conditions

Does this cat have any documented health conditions or waivers?

No Yes

Health condition / waiver details (from kennel paperwork)

Medical follow-up at Cat Haven Vet Clinic required?

No Yes

Microchip Registry (Change of Ownership)

Does this cat have an existing microchip registration with a registry?

No Yes

Select which registries apply (check kennel paperwork):

AAR (Australasian Animal Registry) CAR (Central Animal Records) Global Micro Animal Registry Petsafe

Acknowledgements

New owner to read and tick each item

New Owner Acknowledgements

I have been informed of and accept the health conditions noted for this cat prior to adoption, including any health waivers attached to the kennel paperwork.

I acknowledge that I am required to register my cat with my local council within 14 days of adoption, as required by the Cat Act 2011 (WA).

I acknowledge that my cat has been microchipped and I accept responsibility for transferring the microchip registration into my name on the relevant registry within 14 days.

I acknowledge my cat's next vaccination due date and understand it is my responsibility to ensure vaccinations are maintained. I have been advised of this date by the adoption team.

I have been advised of my cat's next flea and worming treatment dates and understand it is my responsibility to maintain this schedule.

I have been informed of the benefits of keeping my cat indoors and understand the shelter's recommendation for indoor living, particularly given local wildlife and road safety.

I confirm that all information I have provided on this form is true and correct to the best of my knowledge.

I confirm I have read and understood all of the above acknowledgements.

Signature

New owner to sign below using finger or stylus

New Owner Signature

Sign here with finger

Review

Check all details before submitting

Cat Details

Veterinary Dates

New Owner

Health & Microchip

Submission

Staff / Volunteer Name *

Please enter your name

✅

Adoption Submitted

The adoption for has been added to the pending queue.
Please walk the new owner to reception with their kennel paperwork.