Feline Behavior History Form
Please complete this form as best as possible.
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Is it OK to text you at this number for appointment reminders?
No
Yes
Basic Pet Information
What is your cat's name?
Where did you get this cat? Rescue, stray, given to you, breeder, or other?
How old was your cat when you obtained them?
Was your cat already spayed or neutered when you got them? If not, what age did you have them spayed or neutered?
Why did you want a cat?
Why did you choose or decide to keep this particular cat?
Write whatever you know of your cat's history prior to you owning them.
Please describe your cat's personality.
About Your Cat's Home and Lifestyle
Please write the names of all people living in or frequently visiting your home. Include the ages for people under 18 years.
Please list all the pets in the home, including this pet, in the order they became part of your family. Include their species, breed if applicable/known, sex, if they are spayed or neutered, the age at which they were obtained, and the age they are now.
Describe this cat's relationship with each person in the home.
Describe this cat's relationship with each of the other pets in your home.
Please describe your cat's feeding schedule: who feeds your cat, what they eat and how much, favorite treats, where your cat is fed, etc.
Has your cat's appetite changed recently?
No
Yes
Not sure
If yes or not sure, please describe the changes.
Does your cat go outside?
No
Yes
Does your cat have free access to outside through a pet door, or does someone let the cat inside and outside when the cat chooses?
Inside only
Pet door
Someone lets them in and out
If your cat goes outside, how long do they stay out?
If your cat goes outside, where do they go?
Porch or very close to home
Fenced yard
Wherever I go, they follow
Far and wide
No idea
Does your cat encounter any non-household cats, either outside, or seeing them from inside the home? If yes, please describe their interactions if known.
Describe a typical day in the life of your cat. Include where they rest during the day, sleep, eat, etc.
How does your cat behave with familiar visitors?
How does your cat behave with unfamiliar visitors?
How do you play with your cat?
Have there been any changes to your household recently? Addition of new people or pets, someone moved out of the home, etc?
Elimination Behaviors
Do you provide a litter box for your cat?
No
Yes
Does your cat eliminate outside the litter box? Check all that apply
No
Always urinates in the box
Urinates in the box sometimes but not all of the time
Always urinates outside of the box
Always defecates in the box
Defecates in the box sometimes but not all of the time
Always defecates outside of the box
Not sure about the elimination habits of this cat
If you answered no to one or both questions above, skip to the Territorial Behavior section.
How many litter boxes are provided?
Where are the litter boxes located?
What type of litter is used?
Have you made any changes to the litter box situation recently? Number, location, type of litter box, or type of litter?
How often are the litter boxes scooped?
How often are the litter boxes emptied and cleaned?
Describe the steps and products used to clean the litter boxes.
Does your cat bury its urine?
No
Yes
Not sure or don't know
Does your cat bury its feces?
No
Yes
Not sure or don't know
Does your cat scratch and dig in the litter box?
No
Yes
Not sure or don't know
Elimination Problems
If your cat urinates outside of the litter box, please describe where you find the urine, when the cat urinates outside of the box, and how long the behavior has been going on.
If your cat defecates outside of the litter box, please describe where you find the urine, when the cat urinates outside of the box, and how long the behavior has been going on. Please be as specific as possible. For urination outside the box, please note if the urination is against a vertical surface (wall, furniture) or on a horizontal surface (type of flooring, rug, clothing, etc.).
Have you ever caught your cat eliminating outside the litter box?
No
Yes, urinating only
Yes, defecating only
Yes, urinating and defecating
If yes, describe what you did at the time, and the cat's response to your actions.
What have you done so far to correct the problem? What has been the response?
Submit
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