CAT BEHAVIOURAL INFORMATIONVickyDay2020-05-18T07:21:22+00:00 Please complete the form below to help us better understand you and your cat's needs. CAT BEHAVIOURAL INFORMATION FORM Please enable JavaScript in your browser to complete this form.CLIENT INFORMATIONName *FirstLastAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodePhone Number *Email *GENERAL INFORMATION ABOUT YOUR CATCat's Name *Cat's Breed *Cat's Date of Birth *Please select approximate date if exact date not knownCat's Gender *FemaleMaleDate you obtained your cat *Please select approximate date if exact date not knownHas your cat been neutered or spayed? *YesNoAre you the first owner of your cat? *YesNoPlease give history of ownership and where you obtained your cat *Please provide detailVeterinarian Name *Veterinarian Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeYOUR CAT'S DIETWhat do you currently feed your cat?Please include details of any supplements or treatsHow many times a day is he/she fed? Selected Value: 0 Please selectWhen do you feed your cat?Please provide details Does your cat enjoy food or are they a fussy eater?Enjoys foodFussy eaterWhat do you provide your cat to drink?Please provide details How many water bowls does your cat have? Selected Value: 0 Please selectYOUR CAT'S MEDICAL HISTORYDoes your cat have any current or previous medical problems?Please provide details Is your cat on any medication?Please provide details ENVIRONMENTWhat type of house do you live in?Please give general details of layout and size Have you moved since acquiring your cat?Please provide details Does you cat have access to all areas of house?Please provide detailsDoes he/she go outside?Please provide details Does your cat stay in at night or have access outside?Please provide details Does he/she disappear outside for long periods?Please describe what happens Where does your cat sleep during the day and at night?Please describe what happens Does your cat have a scratching post and where is it? Does he/she use it?Please describe what happens Does your cat have access to high up ledges or hidey holes?Please describe what happens TOILETINGDoes your cat use a litter tray? If so what kind of litter do you use? Please provide detailsHow many litter trays do you have and where are they positioned?Please provide detailsAre the litter trays covered or open?CoveredOpenBothPlease selectDoes your cat toilet outside to your knowledge?Please provide detailsHas the cat ever toileted inside in an inappropriate place?Please provide detailsFAMILY MEMBERSHow many people are in your household?Please list and give ages of any childrenDoes everybody in your household interact with the cat?Please provide detailsDoes the cat interact with everybody in your household?Please provide detailsDo you have any other pets?Please provide type, age and gender of any other animals and describe your cat’s relationship with these animalsHUMAN INTERACTIONPlease describe any toys your cat has? Please provide detailsDoes your cat play alone or with you? Please provide detailsDoes your cat follow you at home? Please provide detailsDoes your cat sit on your lap or anyone else's lap?Please provide detailsOTHER CATSAre there other cats in the neighbourhood?Please provide detailsDo they come into your garden or house?Please provide detailsHow do they interact with your cat?Please provide detailsIf there are other cats living in your house can you describe their relationshipsPlease provide details including if they sleep together, groom each other and eat togetherYOUR CAT'S SPECIFIC PROBLEMPlease describe the problems you are having with your cat in as much detail as possibleWhat happens immediately before these behaviours are displayed? Try to think about what you and your cat are doing when the problem occursWhat happens immediately after these behaviours are displayed? Again, try thinking about what you do and what your cat doesWhen did the problem first start occurring and when did you start to see it as a real problem?Please provide as much detail as possibleAre there any particular circumstances in which the problem occurs now?How frequently does the problem occur?Is it becoming more frequent, less or about the same?More frequentLess frequentAbout the sameDoes it always occur in the same place?Please provide detailsWho is usually present at the time of the incident?Please provide detailsWhen was the last incident?Please provide as much detail as possiblePlease describe anything attempted to previously cure this problemPlease provide as much detail as possibleHas your cat previously been assessed by another behaviourist? YesNoIf yes, what was the diagnosis?Please provide detailsOTHER PROBLEMSDoes your cat have any other problems?Please provide detailsWould you describe your cat as:a fussy feederaggressiveactivenervous of anything, such as strangers, loud noisessociableconfident with other catsconfident with humansPlease tick where appropriatePlease provide any further details you think might be importantREHABILITATIONHow much time do you feel you can commit to working to solve the problems?What is your ideal end scenario to achieve from this behaviour assessment?What would you envisage happening if the problems persists?PhoneSubmit
