Feline Behavior History Form The Purrfect Cat

  • Please fill this out as best you can to help me prepare for our consult.

    Thanks and looking forward to talking with you!

  • Disclaimer

    By submitting this questionnaire, I understand that the behavioral recommendations given by Chris Aytug are in no way a substitute for veterinary care.  I understand that the success of a behavior modification plan depends upon my compliance with the instructions and that not all behavior problems can be solved.  In some cases, only an improvement in the behavior may be the best outcome. I release Chris Aytug from any and all liability regarding the health and behavior of my pets, the safety of all people in the household who interact with the cat(s), damage or loss to my property, and in regard to any aspect of the advice given. 

  • Cat Guardian / Owner

  • Format: (000) 000-0000.

  • Cat's Information

  • Sex and status*
  • Declawed?
  • Where did you get this cat?*
  • Have you had a cat before? How long have you had a cat(s)? (check all that apply)

  • Household information

  • Does cat go outside*

  • Behavior History

  •
  • How often does this behavior happen?*
  • If you see the behavior, can you stop / interrupt it?
  • Are you prepared for this issue to take time to resolve, up to several months or more?*
  • Have you considered other options, should this problem not be resolvable to your satisfaction?

  • Environment & Prior Behavior Modification

  • Do you typically reward good behavior? If so, how? (check all that apply)*
  • Pick the statement that describes most closely your cat's typical exercise on an average week (for indoor only cats)*
  • How do you typically correct unwanted/bad behavior? (check all that apply)*
  • How did the cat respond to what you described above?

  • Brief Vet History

  • If you know, approximate date of most recent vet exam
     / /
  • Rows
  • Select all characteristics that describe your litterbox(es)
  • How would you best describe the elimination?
  • How often do you scoop the box(es)?

  • Tell me where your litterbox(es) are located. My first litterbox is located . My 2nd litterbox (if any) is located . My 3nd litterbox (if any) is located 
    .

  • Check the boxes that describe your litterboxes

  •    I use      brand of litter.
    The litter type?  Clumping clay, paper, wood pellets etc.          
    Is litter scented?         

  • Tell me more about the urination? Check all that apply

  • Disclaimer

    By submitting this questionnaire, I understand that the behavioral recommendations given by Chris Aytug are in no way a substitute for veterinary care. 

    I understand that the success of a behavior modification plan depends upon my compliance with the instructions given and that not all behavior problems can be solved.  In some cases, only an improvement in the behavior, and not complete resolution, may be the best outcome.

    I release Chris Aytug from any and all liability regarding the health and behavior of my pets, the safety of all people in the household who interact with the cat(s), damage or loss to my property, and in regard to any aspect of the advice given.

     

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