Behavior United Intake Form for Cats

The insight and knowledge you share about your cat through this quick form allows us to customize a plan before sharing solutions. A certified professional trainer is only a click away. Submitting this form brings you one step closer to gaining more quality cat time! After this form has been submitted and reviewed, scheduling can begin.

Name*

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Primary Phone Number*

Area CodePhone Number

Other people in the home:*

Would you like to receive periodic email updates about upcoming events, classes, and promotions?*

YesNo

How did you hear about us?*

Pet(s) to be seen in session*

Other Pet(s) in home

Please list any other pets in the household and their species, breed, and age

How does your cat interact with humans living in your home? *

How does your cat interact with other animals living in your home?

Do you think your pets get along?

Pet exercise type/frequency plus mental enrichment like cat trees, toys, and food puzzles*

Can your cat see outside animals from inside your home?*

Type of collar/harness/leash

Does Your Cat Go Outside?*

Veterinarian Name/Practice*

Please list any previous or current medical issues your cat has had:*

(Please include any dietary restrictions)

Please List Vaccinations and Dates for Rabies:*

Have you spoken to your vet about your cat's behavior challenges? List any/all behavior medications. *

What type of food (wet/dry) do you feed and how often? Was there a recent diet change?*

Please list any known previous training/methods used:*

What do you use to reward your cat? What is your cat's response?*

What type of correction/punishment do you use with your cat? What is your cat's response?*

How many litter boxes do you have and where are they located?*

Please describe the litter boxes including covered/uncovered and/or motorized hand-free cleaning.*

Which brand/type of litter(s) do you use? Do you use a liner and/or deodorizer?*

How often do you scoop the litter? *

How often do you fully empty and scrub the litter box? Which products do you use to clean the litter box?*

How long has the house-soiling been occurring?*

If your cat urinates outside of the litter box, how would you describe the urine?

If your cat defecates outside of the the litter box, how would you describe the feces?

What are your training goals/reasons for contacting us? Please include how long the house-soiling has been occurring and when you first noticed it. *

Which kind(s) of surface is targeted?*

Is your cat targeting vertical surfaces with urine? If yes, how much volume of urine is being left?*

How often is the house-soiling occurring? *

Has the frequency changed since the problem started? *

Have there been any changes recently (or around the time the problem started)? *

What do you do to clean the soiled areas?*

Have you used any punishment in response to house-soiling (eg: rubbing nose in urine/feces, shouting, spanking, water pistol, confinement)?*

What's your response to house-soiling? Please describe any punishment used,*

Has your cat/pet ever bitten another animal or person? Please describe below and include a description of bite location and severity plus if medical attention was required*

Which training package are you interested in?*

Is your cat/pet possessive or protective of anything? Please describe below:*

Is there anything you would like to add about yourself or your pet(s)?

Cat Behavior Intake Form

Your Information

Pet Information

Medical History

Training and Behavior History