North Royalton AH - Feline Behavior Questionnaire

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FELINE
BEHAVIORAL HISTORY QUESTIONNAIRE

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* This field is required.

Pet's First Name

Pet's Last Name

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ELIMINATION HABITS

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Does your cat’s urine or stools ever appear abnormal, either inside or outside of the box?* This field is required.

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Does your cat have any history of urinary or gastrointestinal tract problems, including a urinary tract infection, obstruction, constipation, or diarrhea?* This field is required.

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* This field is required.

Does your cat urinate outside the box?

If so, please list all locations

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* This field is required.

If your cat urinates outside the box, have you ever witnessed it?

If so, please describe your cat’s posture(i.e., squatting vs. standing, tail down and to the side vs. erect).

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* This field is required.

Does your cat have bowel movements outside of the litter box?

If so, please list all locations.

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* This field is required.

Are there certain objects or materials outside of the box on which your cat will eliminate?

If so, what is it?

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* This field is required.

Does your cat cover up his eliminations in the litter box with litter?

Does your cat ever show scratching or digging behaviors before eliminating outside the box?

What products do you use to clean areas where your cat has soiled?

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LITTER BOX DETAILS

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* This field is required.

How many litter boxes do you have?

Where are the litter boxes located?

What type of litter do you use? Is this a clumping litter?

Do some or all of your litter boxes have covers?

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* This field is required.

Do some or all of your litter boxes have liners?

How deep is the litter in the box?

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* This field is required.

How often do you scoop the urine or stools from the box?

How often do you empty the entire contents of the box and clean it?

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ENVIRONMENTAL

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* This field is required.

Please list all the people living in your household.

Please list all the animals in the household in the order in which they were obtained.

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If you have a multiple cat household, do you ever notice staring, growling, hissing, chasing, or fighting between any of your cats?* This field is required.

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* This field is required.

How does your pet react to strangers?

How does your cat react to loud noises?

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* This field is required.

Has your household changed since acquiring this pet?

If so, when and how?

Was anything unusual going on in your cat’s environment before the onset of the elimination problem?

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* This field is required.

Does your cat have access to the outdoors?

If your cat is strictly indoors, does he have visual access to outdoor cats?

If so, what is his reaction?

FELINE BEHAVIORAL HISTORY QUESTIONNAIRE

FELINE
BEHAVIORAL HISTORY QUESTIONNAIRE