Digital intake form

PPAW Spay/Neuter Clinic Intake Form

Complete this form as soon as possible after trapping for all cats trapped. Your answers go straight to our clinic team.

Session information

Surgery / clinic date*

Personal information

Name*

Phone number*

Email*

Address*

City*

State*

Zip code*

Animal intake details

Animal 1

Cat photo

Optional — upload a photo and we'll fill in the breed, color, and pattern for you.

Sex *

Breed*

Color*

Secondary color

Pattern*

Approximate age (guesstimate)*

Zip code*

Trapping address*

Authorization

I, the undersigned agent of this animal(s), authorize the staff of PPAW Spay/Neuter Clinic to complete the TNVR package outlined below:

Spay or neuter surgery
Rabies vaccination
FVRCP vaccination
Ear tip for community cats

Declarations & initials

I represent and warrant that this animal is a stray with no legal owner.

Initials

To the best of my knowledge, the animal(s) has/has not bitten anyone within the past 30 days. *

Initials

I authorize the use of anesthesia and other medication as deemed necessary by the veterinarian.

Initials

I have been advised as to the nature of this procedure to be performed and the risks involved. I understand that there is always a risk associated with any anesthesia episode, even in apparently healthy animals. I understand that it may be necessary to provide medical and/or surgical procedures which are not anticipated for the safety or care of this animal. I hereby consent to and authorize the performance of such altered and/or additional procedures as are necessary in the veterinarian's professional judgment.

Initials

I understand that if the cat presented is deemed to have poor quality of life or be unfit for outdoor colony life by the veterinarian, it will be euthanized and I will be contacted afterwards.

Initials

I agree that if the cat presented is deemed to be adoptable and there is available foster or placement for the cat, the cat will be surrendered to PPAW.

Initials

Signature

Print name*

Sign name*

By typing your name above you are providing your electronic signature and agreeing to all terms and authorizations on this form.

Having trouble completing this form? Contact our clinic team and we'll help.