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Feline Behavior History

Please complete this form with as much details as possible at least 2 days prior to your appointment. Please videotape your pet performing the behavior(s) before your visit, if possible. Thank you and we look forward to working with you and your pet(s)!

Client Information

Cat Information

Sex *
Neutered/Spayed *
Declawed? *

Referring Veterinarian Information

Chief Complaint

Cat's Environment

11. List all members of your household and their schedules:

12. List all pets in household in the order in which they were obtained:

If you have a multiple cat household, do you ever notice starting, growling, hissing, chasing, or fighting between any of your cats?

Early History




26. How does your cat act with:

Other Information

Medical History

Behavior at the litter box

Litter Box #1

Litter Box #2

Litter Box #3

Litter Box #4

Litter Box #5