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General Information

First Name
Last Name
Address(unless doing online consult)
Email
Phone Number(unless doing online consult)

Pet Information

Name
Breed
Age
How long have you had this cat?
Where did this cat come from?
How old was the cat when acquired?
Gender of cat
Is your cat spayed/neutered?
Does your cat go outdoors?
Is your cat declawed?
What brand of food do you use?
Food type
How do you feed your cat?(Free fed, timed feedings, etc.)
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What is your cat's favorite treat?

Behavior Problem

When was the last time your cat was seen by a vet?
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What is the primary behavior issue?
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When did the problem begin?
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Do you recall anything specific on during the onset of this behavioral issue?(Construction, birth of a baby, parties, houseguests, etc.)
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How often does the behavior occur?
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Has the behavior changed in intensity of frequency?
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What corrections have you tried?
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What disipline have you used?
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Any secondary issues or concerns?
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Urination Habits

How Often Uses Litter Box
If not using box, where is he eliminating?
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How often does your cat urinate in the box and can you describe the size of the urine clumps for me?
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How does the feces look and how often does he go?(Size, amount, firm, soft, formed, runny, bloody, etc.)
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How many litterboxes do you have?
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How many different litter box locations do you have?
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What kind of litterboxes do you have?(Automatic, hooded, etc.)
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Where are the litterboxes?
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Any litterbox liners or mats?
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How often do you scoop the boxes?
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How often do you fully clean the box and refill it?
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What cleaners do you use to clean boxes?(Please describe the scent such as citrus, vanilla, etc.)
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How old is each litter box?
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What type of litter substrate?
Does the cat scratch in the litter before eliminating?
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Does the cat cover his urine or feces?
What brand of litter do you use?
Do you change cat litter brands often?
Do you add any deodorizers to the box?(Baking soda, etc.)
Does cat stand, perch, or stand on edge of box?
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The Environment

Have you moved since getting this cat?
Where does the cat sleep at night time?
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Any areas off limits to your cat or cats?
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List people living in the household (include ages) and their relationship/role in caring for the cat
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List all animals in the household including ages, breeds, and any other info you feel is important
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How does cat get along with the other animals?(fearful, friendly, hostile etc.)
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Cat Social Behavior

Where is the cat when they are alone?
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How does the cat behave once you return?
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Where does the cat stay when you have guests or strangers over at the house?
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How does your cat act with children and adults?
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Does your cat look outside through any windows?
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How does cat act at the vet?
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How is your cat's overally personality?
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Does your cat hiss or growl?
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Does your cat mount other cats, objects, people?
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Does your cat carry toys/objects around the house or “mother” other animals or objects?
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Any biting?
Any scratching?
Any vocalizing?

Play Time Behavior

Do you have cat trees/towers?
Do you have any scratching posts?
Do you trim your cat's claws?
How is your cat's activity level?
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What toys does your cat play with?
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How do you play with your cat?
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Any chewing, suckling or licking items or people?
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Does your cat scratch on items that you wish he would not scratch on?
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Grooming

Does cat groom, bite, or lick excessively?
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Any Bald patches?
Does the cat's skin twitch or ripple?
Any sucking or chewing their tail?

Daily Life

Any changes in routine lately?
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Any activities been stressful to your cat?(parties, construction work)
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Where are food and water bowls at?
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Any excessive eating or drinking?
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Any trouble navigating the house?(going up or down stairs, getting lost, jumping issues, etc.)
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Any current medications now or in the past?
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