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Format: (000) 000-0000.
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- How did you acquire this cat?*
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- If there were aggressive behaviors, what was the result to the victim? (Check all that apply)*
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- How would you describe your cat's appetite? Select all that apply.*
- Please provide information about any routine products, medications, or supplements:
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- From the list below, please check any ailments your pet has experienced within the last year.*
- Does your pet have a relationship with any of the following veterinary specialists?*
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- Please list the human occupants living in your home, whether part or full time. *
- Please list any other pets or animals living in your home, excluding the patient.
- In what sort of home do you and your pet reside?*
- How would you describe the energy in your home?*
- Have you owned a cat in your adult life prior to this one?*
- How do you feed your cat?*
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- Do you need to be present for your cat to eat?*
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- Is your cat allowed outside?
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- Do you have a yard? If yes, check all that apply:*
- Is there any time each day dedicated to play or exercise?*
- Is your cat playful?*
- Is your cat affectionate or cuddly with people in the home?*
- Is your cat affectionate or cuddly with visitors to the home?
- If you have multiple cats, do you ever see them snuggling or grooming each other?
- Does petting (from a human) or grooming (from another cat) ever result in aggressive episodes?
- If you have multiple cats, do you ever see one hissing, swatting, and running away from another?
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- Does your cat like to scratch?*
- Do they scratch inappropriate items?*
- Any inappropriate chewing or consumption of non-food items?*
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- Do you record or monitor your pet when they are home alone?*
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- Does your cat exhibit any of the following behaviors as you are preparing to leave or once you are gone?*
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- How would you describe your cat's ability to learn?*
- Is there any specific time devoted to training each day?*
- Have you ever worked with another behavior specialist or trainer?*
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- Is/are your litterboxes covered?
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- Describe your cat's digging behavior:
- Do you ever see your cat quickly running from the litterbox after eliminating?
- Does your cat ever urinate outside the litterbox?
- Does your cat ever defecate outside the litterbox?
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- Does your cat demonstrate aggressive behaviors in any of the following circumstances? (Aggression is defined as any "distance increasing behavior" and can include stiffening, staring, growling, swatting, hissing, biting, etc.)
- Describe your cat's response in the following situations. Write N/A for situations that do not occur for your cat. *
- Any distress associated noises, storms, or fireworks?*
- Does your cat demonstrate any inappropriate sexual behavior?*
- Is your cat protective of any part(s) of their body?*
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- Does your cat ever demonstrate any of the following behaviors?*
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- Using the scale below, how would you rank your cat's overall behavior? 1 meaning the cat needs to be out of the house ASAP and 10 meaning they are perfect and nothing needs changing.*
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- Should be Empty: