Functional Assessment Questionnaire
Thank you for taking the time to fill out this questionnaire on your cat's undesirable behavior. Please complete one form for one behavior (if there are multiple, please select the most troublesome first). Some of the questions can be tricky. Just answer as much as you can. With this information we can have a good foundation of information and use our time together efficiently!
Guardian's Name
First Name
Last Name
Cat's Name
Cat's Age
Cat's Breed
What are three things about this cat that you really like?
Describe in observable, measurable terms the behavior the cat does that you would like to reduce. (e.g. rather than "he begs for food" you can measure "he paces and meows")
Does the cat have any medical or physical conditions, and if so, is the cat on medication or under other treatment for them?
Describe the cat's diet and eating routines:
Describe the cat’s typical activity schedule:
Describe the cat’s typical rest and sleep schedule:
Describe the cat’s living area:
When does the undesirable behavior occur (times of day)?
Where does the undesirable behavior occur (physical setting, location, indoors/outdoors, a particular room, etc.)?
Does the undesirable behavior occur when certain items or equipment are present (e.g. food bowls, leashes, toys, chews)?
Who is present when the undesirable behavior occurs? People, other cats, specific people/animals?
With whom is the undesirable behavior most likely to occur?
Does the undesirable behavior occur during a specific activity? If so, what?
Does the undesirable behavior immediately follow a caregiver’s demand or request?
What environmental event or condition, including the behavior of the caretaker, is the most immediate predictor of the behavior?
Under what conditions does the undesirable behavior NOT occur?
What does the cat gain by behaving this way (e.g., attention, access to an item or activity, or sensory stimulation)?
What does the cat avoid by behaving this way (e.g., a demand or request, proximity to a person or other animal, or sensory stimulation)?
What behavior the cat already knows could serve the same purpose as the undesirable behavior (i.e., provide the same consequences)? Example: Rather than hit his guardian with a paw for attention the cat could head bunt.
What behavior do you ultimately want the cat to exhibit?
What, if anything, does the cat need to learn before we can teach the desired behavior?
What has already been tried to change this behavior?
What food does your cat find rewarding?
What items/toys does your cat find rewarding?
What activities does your cat find rewarding?
Please verify that you are human
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