Intake Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Have you already contacted Max? If not, email max@felinefriendsofsammamish.org *YesNoYour Name *Your Email *Phone Number (if not already in our system)Date of Intake / Transfer *Cat Name (if not known, Cat 1, Cat 2, etc or collar color) *Sex *FemaleMaleUnknownFur Length *Short hairMedium hairLong hairBreed (optional, i.e. Siamese, Ragdoll, etc.)Approximate Age *Weight (in pounds) or approximate *Color *Any special features / markings (polydactyl, etc)Microchip number and manufacturer (if available)Spay / Neuter *YesNoRabies Vaccine – DATE. Email Rabies Certificate to liz@felinefriendsofsammamish.orgViral test (FeLV/FIV) – date and results. Email document to liz@felinefriendsofsammamish.orgFVRCP – list datesDeWorming TreatmentPyrantelPonazurilPraziquantelDeWorming DateFlea TreatmentsRevolution/SelamectinCapstarFlea bath / flea dipFlea Treatment DateRingworm treated or noticed – Location of ringwormOther medical issues, concerns: *SocializationCatsDogsKidsSkittishFood: what has kitty been eating?Previous Situation / LocationFosterStraySurrenderVet Records – List Vet/Clinic Name and CityHistory; any additional information we should be aware of:Location/Placement once transferred to FFoSStudio in RentonFosterNot yet determinedFFoS Foster Name (if known)Are you the owner of the cat(s)? *Yes – Please certify your surrender belowNo – I’ve notified owner and allowed 15 days for responseNo – I’ve made every attempt to ascertain the ownerCat Surrender CertificationI hereby certify that I am the rightful owner/custodian of the cat who is listed above. I hereby surrender any and all property rights to the cat. I certify that no other person has a right of property to the cat. I understand that by surrendering my property rights to the cat, the cat will be transferred into the custody of Feline Friends of Sammamish. I also hereby certify that the cat has not bitten another animal or human within the past 10 days. I understand that once I relinquish the cat, the cat will not be available to be returned. I certify that all medical conditions and/or concerns have been disclosed along with vaccination history.Submit Email separately any vet records to liz@felinefriendsofsammamish.org
