LITTER BOX 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.
How many cats do you have?*
1
2
3
4+
How many litter boxes do you have? *
1
2
3
4+
How many litter boxes are open?*
0
1
2
3
4+
How many litter boxes are covered?*
0
1
2
3
4+
How many litter boxes are square/rectangular?*
0
1
2
3
4+
How many litter boxes are large?*
0
1
2
3
4+
How many litter boxes are small?*
0
1
2
3
4+
How many litter boxes are deep?*
0
1
2
3
4+
How many litter boxes are shallow?*
0
1
2
3
4+
How many litter boxes have Liners?*
0
2
3
4+
How many litter boxes have no Liners?*
0
2
3
4+
What kind of litter material are in the boxes?*
Anything I can get with a coupon
Clumpable
Recyclable
Plain Clay
Deodorized
Playground sand
Ashes
Potting soil
Gravel/Rock
Saw Dust/Wood chips
Wheat Husks/Corn Cobs
Recycled, pelleted newspaper
Shredded Paper/Shredded Paper toweling
Other
None (Empty Box)
How many litter boxes are in a closet?*
0
1
2
3
4+
How many litter boxes are in the kitchen?*
0
1
2
3
4 +
How many litter boxes are in the bathroom?*
0
1
2
3
4+
How many litter boxes are in the bedroom?*
0
1
2
3
4+
How many litter boxes are in the attic?*
0
1
2
3
4+
How many litter boxes are in the entryway?*
0
2
3
4+
How many litter boxes are in the pantry?*
0
1
2
3
4+
How many litter boxes are in the basement?*
0
1
2
3
4+
How many litter boxes are in the stairwell?*
0
1
2
3
4+
How many litter boxes are in the laudryroom?*
0
1
2
3
4+
How many litter boxes are outside?*
0
1
2
3
4+
Does the cat scratch in the box before going ?*
Yes
No
Does your cat cover up feces?*
Yes
No
Does your cat scratch outside the box?*
Yes
No
Are the litter or any liners you use scented?*
Yes
No
How frequently is the litter changed?*
Daily
Weekly
Twice Weekly
Twice a Month
Monthly
How frequently is the litter box washed?*
Daily
Weekly
Twice Weekly
Twice a Month
Monthly
Are deodorants/bleaches/Ammonia used to clean box*
Yes
No
Does the cat eliminate only/mostly in secret?*
Yes
No
Does cat use box differently near other animals?*
Yes
No
Does the cat immediately use a cleaned box?*
Yes
No
Does the cat ever vocalize when eliminating? *
Yes
No
Does the cat pee/poop outside the box?*
Yes
No
Does the cat eliminate in a room where no box?*
Yes
No
Is there anything else you feel we should know?*
Yes
No