• Jones Animal Behavior

    Feline Behavior History Form
    Jones Animal Behavior

  • It is strongly recommended that you:

    • Fill out this form on a desktop or table, as cell phoness are not as compatible
    • Save each section, in case there is an issue later
  • Email
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  • Primary Cat's Info

  • Sex
  • Declawed?
  • Where did you get this pet?

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  • Family Details

  • Describe all HUMANS in this cat's life (including yourself)
    Rows
  • Describes any ANIMALS in this cat's life
    Rows

  • Concerning Behavior

    Inter-pet conflict
  • Is your cat having conflict with any other pets?

  • Describe the first pet with whom there is conflict

  • Species

  • Sex
  • What are you seeing? check all that apply)

  • Describe the second pet with whom there is conflict

  • Species

  • Sex
  • What are you seeing? check all that apply)

  • Concerning Behavior

    Litter Box Avoidance
  • Is your cat having any litter box-related problems?
  • How often do the following occur OUTSIDE the box?
    Rows
  • What materials is cat eliminating on? (ex: area rugs, bathtub, tile, clean laundry, etc.)
  • WHERE in the home is the soiling occurring? (ex: basement, son's bedroom, etc.)
  • Describe any urine found outside the box (Check all that apply)

  • Describe any feces found outside the box (Check all that apply)

  • How does this cat access water? (check all that apply)

  • Describe your litter boxes
    Rows
  • How often do you scoop?

  • How often do you fully empty & wash box and replace litter?

  • Concerning Behavior

    Human-Directed Aggression
  • Is this cat displaying aggression toward humans?
  • Check all that apply related to biting:

  • Check all that apply related to scratching

  • Check all that apply:

  • Who has aggression been directed toward? (check all that apply)

  • Describe most severe instance:

  • Self-Assessment

  • Are you prepared for it to take time to resolve, up to several months or more (be honest about this/there will be no judgement)
  • Have you considered other options, should this problem not be resolvable to your satisfaction?

  • Training History

  • How do you typically correct unwanted/bad behavior? (check all that apply)

  • How did the pet respond to what you described above?

  • Health & Nutrition

  • Do you have pet insurance?
  • Describe this cat's feeding (Check all that apply)

  • Indicate cat's activities (check all that apply)

  • Cat goes outside (check all that apply)

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  • Mentee Agreement

    I work with several mentees interested in my field. Occasional they will shadow my sessions

  • Agreement, Waiver, & Release

  • Should be Empty: