Cat behaviour form
behaviour.services
DETAILS OF YOUR HOUSEHOLD
Your Name (person completing the form)
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Address
Street Address
Street Address Line 2
City
Post Code
Please list details of human members of your home (please include yourself)
Rows
Name
Age
Relationship with cat
Family member
1
Family member
2
Family member 3
Family member 4
Complete the details for the cat in question. If the problem relates to behaviours between multiple pets then please choose one pet here and complete details for the others in the table below.
*
Rows
Name
Age
Breed
Gender
Neuter status
Your cat's details
For how long have you owned your cat?
How would you describe your cats personality
Please list details of the other animal members of your home (furry or not!)
Rows
Name
Species
Age
Gender
Neuter status
Relationship with pet?
Pet 1
Pet 2
Pet 3
Pet 4
Pet 5
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MEDICAL (AND MEDICATIONS)
Medical problems
Rows
Please provide a list/details here
Ongoing medical problems
Historic medical problems
Do you have any concerns regarding your cats health?
Medications
Rows
Please provide a list/details here
Medications (including behaviour) your cat is currently on
Supplements e.g. herbal your cat is currently on
Behaviour medications that have been tried in the past
Rows
Please give details here
Please note down approximately how long your cat spends sleeping.
Have there been any changes in the amount of time your cat spends sleeping?
Are there any parts of their body your cat grooms less than others?
Does your cat jump on high surfaces?
Is your cat as active as it used to be (consider any changes in the surfaces they jump up on).
How often does your cat engage in play?
Have there been any changes to the frequency or duration of play?
If your cat goes outdoors, has the amount of time your cat spends outdoors changed?
Does your cat dislike being touched in any particular areas? Have these areas changed?
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DETAILS OF THE PROBLEM BEHAVIOURS
Please answer these questions for each problem in turn
Problem behaviour one
What is the problem behaviour? (Examples will be asked for later)
*
How important is this problem to you?
Low importance
Medium importance
High importance
What is the approximate date the problem started?
Please list all of the situation(s) the problem occurs in (please describe how these may have changed over time if applicable)
How often does the problem occur? (please feel free to state per day / per week / per month depending on frequency)
Please describe the details of the first incidence of the problem you can recall
Please describe the details of the most recent incident you can recall
Please describe the details of the most memorable incident you can recall
What has been done to correct the problem? Please note whether each intervention has made the problem better, worse, has had no effect or if there has been a variable effect.
Rows
The intervention you tried
Approximate dates
Do you feel this made the problem better, worse, has had no effect or if there has been a variable effect?
Intervention 1
Better
Worse
No Effect
Variable Effect
Intervention 2
Better
Worse
No Effect
Variable Effect
Intervention 3
Better
Worse
No Effect
Variable Effect
Intervention 4
Better
Worse
No Effect
Variable Effect
Intervention 5
Better
Worse
No Effect
Variable Effect
Intervention 6
Better
Worse
No Effect
Variable Effect
Overall, is the problem getting better, not changing, getting worse or is variable?
Do you suspect a cause?
What do you do when your cat behaves in a way you like?
What do you do when your cat behaves in a way you don't like?
Is there anything else you think is relevant to mention now? We will discuss all details within the consult.
Problem behaviour two
What is the problem behaviour? (Examples will be asked for later)
How important is this problem to you?
Low importance
Medium importance
High importance
What is the approximate date the problem started?
Please list all of the situation(s) the problem occurs in (please describe how these may have changed over time if applicable)
How often does the problem occur? (please feel free to state per day / per week / per month depending on frequency)
Please describe the details of the first incidence of the problem you can recall
Please describe the details of the most recent incident you can recall
Please describe the details of the most memorable incident you can recall
What has been done to correct the problem? Please note whether each intervention has made the problem better, worse, has had no effect or if there has been a variable effect.
Rows
The intervention you tried
Approximate dates
Do you feel this made the problem better, worse, has had no effect or if there has been a variable effect?
Intervention 1
Better
Worse
No Effect
Variable Effect
Intervention 2
Better
Worse
No Effect
Variable Effect
Intervention 3
Better
Worse
No Effect
Variable Effect
Intervention 4
Better
Worse
No Effect
Variable Effect
Intervention 5
Better
Worse
No Effect
Variable Effect
Intervention 6
Better
Worse
No Effect
Variable Effect
Overall, is the problem getting better, not changing, getting worse or is variable?
Do you suspect a cause?
Is there anything else you think is relevant to mention now? We will discuss all details within the consult.
Problem behaviour three
What is the problem behaviour? (Examples will be asked for later)
How important is this problem to you?
Low importance
Medium importance
High importance
What is the approximate date the problem started?
Please list all of the situation(s) the problem occurs in (please describe how these may have changed over time if applicable)
How often does the problem occur? (please feel free to state per day / per week / per month depending on frequency)
Please describe the details of the first incidence of the problem you can recall
Please describe the details of the most recent incident you can recall
Please describe the details of the most memorable incident you can recall
What has been done to correct the problem? Please note whether each intervention has made the problem better, worse, has had no effect or if there has been a variable effect.
Rows
The intervention you tried
Approximate dates
Do you feel this made the problem better, worse, has had no effect or if there has been a variable effect?
Intervention 1
Better
Worse
No Effect
Variable Effect
Intervention 2
Better
Worse
No Effect
Variable Effect
Intervention 3
Better
Worse
No Effect
Variable Effect
Intervention 4
Better
Worse
No Effect
Variable Effect
Intervention 5
Better
Worse
No Effect
Variable Effect
Intervention 6
Better
Worse
No Effect
Variable Effect
Overall, is the problem getting better, not changing, getting worse or is variable?
Do you suspect a cause?
Is there anything else you think is relevant to mention now? We will discuss all details within the consult.
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HOME ENVIRONMENT
What type of home layout do you have?
What degree of access does your cat have to the home?
Does your cat have access to a garden?
If your cat goes outdoors how does it get access in and out of the home?
Rows
Controlled access e.g. door / window
Microchip / collar controlled cat flap (Locked at times)
Microchip / collar controlled cat flap (Never locked)
Standard cat flap usable by any cat (Locked at times)
Standard cat flap usable by any cat (Never locked)
How does your cat exit your home?
How does your cat re-enter the home?
What is a typical 24 hours in the life of your cat. Please indicate times when your cat's routine may change.
Please provide a floor plan of your home. Indicate where the following resources are: litter trays, beds, water bowls, food bowls, scratch posts, toys and any other resources. If this is a multi-cat household then please indicate which cat's predominantly use which resources.
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Litterboxes
Do you have a litterbox?
Yes
No
Please provide details of all litterboxes
Rows
Details of box 1
Details of box 2
Details of box 3
Details of box 4
Details of box 5
What type of litter is used?
Has the litter type being changed recently?
What is the approximate depth of litter used?
Is the box covered or uncovered?
How often is soiled matter scooped out?
How often is fresh litter added?
How often is the entire litter box cleaned, washed and dried with all litter replaced?
Location of box in the home
Is this box used for urine, faeces or both?
Is a liner used?
What is the access side height of the tray (the length needed to step over to access the tray)
How
long is the box relative to the length of your longest cat?
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Multi-cat home
Do either of the cat's sleep touching/intertwined (allowing their scent to mix)
Do either of the cats spend time mutually grooming each other within one sitting (allowing their scent to mix)
Do either of the cats spend time rubbing against each other's body's as they walk past each other (the way a cat may rub against a human's leg)
If you see any chasing occurring who typically initiates a chase? Is the chasing reciprocated?
Do any of the cat's growl or hiss at each other at times?
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Essential changes needed
What are the essential changes you need to continue living with your cat?
Under what circumstances would you consider euthanasia?
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