CAT BEHAVIORAL QUESTIONNAIRE
Please review this entire questionnaire first, then go back and answer the questions as thoroughly as possible. Please return the questionnaire before the appointment if possible. Otherwise please have it with you at time of the appointment. If there was an incident (such as a bite), if possible, please ask those who were present for input as well.
Today’s Date*
Your Name*
Pet’s Name and Age*
What is your pet's sex?*
Male
Female
Have you had pet's before you got this pet? *
Yes
No
Have you had a cat before?*
Yes
No
What is your pet’s breed? *
Have you owned this breed before?*
Yes
No
Why did you choose this animal/breed?*
Has your pet been spayed/neutered? *
Yes
No
At what age was your pet spayed/neutered?
Where did you get your pet?*
Stray/Found by me or someone in my household
Breeder
Animal Shelter
Pet Rescue
Advertizement (Not Breeder/Store)
Pet Store
Given to me by a family member or friend
Baby of my other pet(s)
How long have you had your pet? *
How old was he/she when you brought them home?*
Approximate date of last Veternarian visit? *
List their medical conditions/allergies? *
Vaccinations have they had in the last 12 months?*
What brand/type of food does your pet eat?*
How many times a day is your pet fed?*
1 Time
2 Times
3-4 Times
Free Feeding
How many days a week are away from home? *
0 Days
1-5 Days
6-7 Days
How often is your pet given treats?
0 Times
1-5
6+
How many hours are you away on those days?
1-5 Hours
6-9 Hours
10+ Hours
How do you prepare to leave home?*
Ignore them
I breifly say goodbye to them
I pet and talk to my pet for awhile
What does your cat do as you prepare to leave?*
Where does your cat spend most of their time?*
Inside in a cage/crate
Shut inside a room
Indoors free roaming (unsupervised)
Outside no enclosure (unsupervised)
Indoors free roaming (supervised)
Outside no enclosure (supervised)
How many times a day does your cat go outside?*
Let out in morning and comes In at night
Goes In and out Cat Door when they want
Put in cat enclosure part of the day
Never, its an Indoor Cat
I take my cat on a walk
Do you play with your cat daily?*
Yes
No
Where does your pet sleep?*
In or on your bed
In a bed/crate in your bedroom
In a crate/pet bed in another room
Anywhere it wants
On the floor or other spot in your bedroom
On the floor in another room
What kind of home do you live in?*
Apartment
Townhome
House
Farm/Ranch
List name, species, breed and age of other pets:*
List name, sex and age of people *
What are the issue are you most concerned with?*
Aggression toward unfamiliar animal(s)
Aggression toward another pet
Aggression toward family member(s)
Guarding food/toys/possessions/other
Aggression toward visitors
Aggression toward unfamiliar people in public
Aggression when handled/picked up
Litter Box problems
Chewing/eating inappropriate things
Not listening to commands
Biting/Clawing
Separation Anxiety
Stealing Food/Begging
Jumping up on people
Nuisance Meowing
Approximate date/time this behavior started?*
Did a person move in/out of home when it started?*
Yes
No
Was a new baby in home when it started?*
Yes
No
Was there a change in owner’s work hours?*
Yes
No
Was there a change in routine?*
Yes
No
Recent vaccination/medication change ?*
Yes
No
Did a pet/person in the home pass away?*
Yes
No
Was another pet lost/re-homed?*
Yes
No
New medical treatment/surgery?*
Yes
No
What has been done to address the issue so far?*
Use of physical corrections
Sent away from home
Previous training/ behavior modification
Environmental changes
Have you moved recently
Changed your pet’s diet recently
After the pet’s behavior was addressed:*
It improved
It worsened
It stayed the same
Please, list what commands your cat knows:
How many litter boxes do you have? *
Are your cat's front feet declawed?*
Yes
No
Are your cat's back feet declawed?*
Yes
No
If so, what age were they declawed?