form center

2. Due to the large number of kittens we are currently caring for, out-of-county appointments are temporarily suspended.
4. First Name*
5. Last Name*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Email Address*
16. Can we text this phone number?*
    -- Select One --YesNo
18. How many total cats will you need assistance with?*

20. Appointments are made only for a cat that is identified on this application.  Cats that are not identified will not be accepted at time of appointment.

24. Cat's Name:
26. Cat #1: Age (estimate)
27. Color
    -- Select One --BlackWhiteSilverBrownCalicoOrangeTuxedoTanTortie
28. Secondary Color
29. Hair Length
    -- Select One --Short HairLong HairHairless
31. Gender

    1. Male

    1. Female

    1. Unknown
32. Are you able to handle this cat?
    -- Select One --Yes, I can pet this cat.Yes, I can pet and pick up this cat.Neither
33. Where does this cat live?
    -- Select One --Indoor onlyOutdoor onlyBoth

    Choose one
37. Cat #2: Name
38. Cat's Age (Estimate)
39. Color
40. Secondary Color
42. Hair Length
    -- Select One --ShortMediumLongHairless
43. Gender
    -- Select One --MaleFemaleUnknown
44. Are you able to handle this cat?
    -- Select One --Yes, I can pet this catYes, I can pet and pick up this catNeither
45. Where does this cat live?
    -- Select One --Indoor onlyOutdoor onlyBoth Indoor / Outdoor

    Choose one
49. Cat #3: Name
50. Cat's Age (Estimate)
51. Color
52. Secondary Color
54. Hair Length
    -- Select One --ShortMediumLongHairless
55. Gender
    -- Select One --MaleFemaleUnknown
56. Are you able to handle this cat?
    -- Select One --Yes, I can pet this catYes, I can pet and pick up this catNeither
57. Where does this cat live?
    -- Select One --Indoors onlyOutdoors onlyBoth indoor / outdoor
61. Cat #4: Name
62. Cat's Age (Estimate)
63. Color
64. Secondary Color
66. Hair Length
    -- Select One --ShortMediumLongHairless
67. Gender
    -- Select One --MaleFemaleUnknown
68. Are you able to handle this cat?
    -- Select One --Yes, I can pet this catYes, I can pet and pick up this catNeither
69. Where does this cat live?
    -- Select One --Indoors onlyOutdoors onlyBoth indoor / outdoor
73. Cat #5: Name
74. Cat's Age (Estimate)
75. Color
76. Secondary Color
78. Hair Length
    -- Select One --ShortMediumLongHairless
79. Gender
    -- Select One --MaleFemaleUnknown
80. Are you able to handle this cat?
    -- Select One --Yes, I can pet this catYes, I can pet and pick up this catNeither
81. Where does this cat live?
    -- Select One --Indoor onlyOutdoor onlyBoth indoor / outdoor
85. If more than 5 cats, please describe each cat.
87. Do any of these cats have nursing kittens?

    1. Yes
    2. No
89. How did you get this/these cats?

    1. Appeared / Found on my property or neighborhood
    2. Given to me by a friend / family member

    1. Online / Social Media (eg. Facebook Marketplace, Craigslist)
    2. Other
91. Any other information you would like us to know?
93. If qualified, on the scheduled day your cat(s) will receive spay/neuter surgery, rabies vaccination, FVRCP vaccination, a microchip, and an eartip procedure at no cost.

    You may elect to purchase the following: *3-month flea and tick prevention - $15 **Dewormer (you will administer to your cat 2 days after surgery) - $15 ***We do not provide blood tests for FIV/FeLV

95. Ear Tip
    
97. *example of an eartip - the universally-recognized sign of a cat who has been spayed or neutered
99. Would you like to pay $50 per cat to opt out of the mandatory ear tip?*

    1. Yes
    2. Maybe, I need more information
    3. No
101. 1. I understand that through the Community Cat Program, these cat(s) will receive spay or neuter, microchip, rabies shot and an ear tip to the left ear. (The eartip is a requirement of the Community Cat Program.)
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103. 2. I understand that the spay/neuter surgery carries a risk of complications, including death, to the animal(s). I hearby assume full responsibility and agree to waive any and all claims against Williamson County Government and Williamson County Animal Center ("WCAC") and their agents, officers, veterinarians, contractors, volunteers and employees in the event of escape, sickness, injury, complications or death of my animal(s) related to the spay/neuter surgery.
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105. 3. I understand that animals may be groggy when released, and should be kept in an enclosed area for 24 hours after the procedure. I will make every attempt to observe the cat(s) for post-surgical complications including, but not limited to, incision infection and lack of appetite. In case of post-surgical problems, I agree to arrange the appropriate veterinary care at a full service facility at my own expense.
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107. 4. I agree to retrieve my cat(s) between 3pm and 5pm the same day as surgery. Cats not picked up the day of surgery may be considered abandoned and subject to citation.
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109. 5. To the fullest extent permissible under applicable law, I agree to hold harmless, indemify, and release Williamson County Government and WCAC, their agents, officers, veterinarians, contractors, volunteers and employees, from any and all loss, injury, liability, damage, or cost I may incur or suffer due directly or indirectly from the spay/neuter surgery and removal and housing of this animal whether caused by Williamson County Government or WCAC, their officers, agents, veterinarians, volunteers or employees.
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111. 6. I VOLUNTARILY SIGN THIS RELEASE AND WAIVER OF LIABILITY, and further agree that no oral representations, statements or inducements, apart from this written agreement have been made. I further attest that the below listed cat is my pet or in my custody of care, and that I have the authority as the owner or agent to authorize the removal and housing by WCAC.
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113. I HAVE READ AND UNDERSTAND THE ABOVE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT AND I AGREE TO BE LEGALLY BOUND BY ALL TERMS OF THIS AGREEMENT AND THAT IT IS INTENDED TO BE AS BROAD AND INCLUSIVE AS PERMITTED BY APPLICABLE LAW.
     Signature of Owner or Agent:
114. Date:

116. *Please be sure to check your spam/junk folder if you do not receive a response to your application within 2-3 business days.*

118. The community cat program is made possible by donations.
     Suggested donation per cat - $15
Leave This Blank:


120. 1. Receive an email copy of this form.
121. Email address

     This field is not part of the form submission.

122. Submit

* indicates a required field