Chausie Rescue Veterinarian Reference Form

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Please complete this form. Click on Submit when ready to send.

To Whom It May Concern:

has applied to Chausie Rescue Group to adopt or foster a Chausie cat. Because distance often precludes a home visit, we would like to obtain a reference to ensure we are making an appropriate placement. We would appreciate your time in assisting us by filling out this reference form:
 

Veterinarian's name:
 

Clinic Name:
 

Address:
 

City: State: Zip:
 

Daytime Phone #:
 

Fax #:
 

How long have you known this client?
 

Would you consider him/her a responsible pet owner?
 

To the best of your knowledge, are his/her animals up-to-date with their shots?
 

Have they been tested for FeLV/FIV? Results
 

Are there any reasons why you would NOT recommend placement of a Chausie cat with this client?

 

Additional Comments:

 

May we telephone you if needed?
 

Signature:
Date of receipt:

 

 

 

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Last modified: 11/26/08