Needs Assessment Form

Please fill out this form if you have never used our services before.  This form will help us know a little more about your situation so that we can help you.  If you have any questions about this process, please email us for assistance.

Do NOT use this form if you are inquiring if we are taking in cats for our own adoption program as we do not take owner surrenders from the public and we cannot list owned cats in the RAP program. Entrance into our own adoption program is solely at our discretion and preference given to only the most urgent of medical cases.  We can assist with spay/neuter services, some medical needs, and give advice on how to rehome a cat if needed, but we are not able to admit cats under most circumstances into our own adoption program.  Please do not ask because your request will be declined.

Once you have completed this form, you can request to borrow traps and other equipment.

Name:

Email Address:

Street Address:

City: State:

Zip: County:

Home Phone:

How many cats do you need help fixing?
Please use your best judgment on the next series of questions:
Is the cat friendly and can be picked up and placed in a carrier without struggle?  Yes No I don't know

Do you think any of the cats are pregnant?  Yes No I don't know

Do you think any of the cats are nursing kittens?  Yes No I don't know

Do you think any of the cats are under 2 lbs or 2 months?  Yes No I don't know

Do any of the cats look sickly or injured?  Yes No I don't know

If you answered yes to the last question, please elaborate:
 Goopy eyes Snotty nose Sneezing Coughing Other:

Will you need to borrow traps to capture cats?  Yes No I don't know

If you answered "Yes" to needing to borrow traps, please visit our Borrowing Equipment page to get traps and other equipment after you submit this form.


Are there friendly cats you'd like to see found a forever home? If so, we can send you information about RAP - Rehoming Assistance Program.
 Yes No Maybe


Please give us any more information you feel is important for us to know:


Our cost to spay a female is $45. Our cost to neuter a male is $30. Can you help us with any of this cost?

Please select the day of week and time you plan on initially picking up traps or bringing us your first cat. Be sure to check our web page to make sure we have no closings scheduled.
 Sunday 6:00-7:30 pm Monday 6:00-7:30 pm Tuesday 6:00-7:30 pm

How did you hear about us?

If Word of Mouth/Referral, who referred you? If referral was from another rescue or business, please let us know that as well. (They will not be solicited in any way)

If Other, please explain.