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Cat history form

Before your consultation

Cat history form

Tell us about your cat, their daily life and the behaviour you would like help with.

How to prepare and send your cat’s floor plan

Please answer as fully as you can. Fields marked with an asterisk are required.

PetBC - Cat history questionnaire

Notify

Your details
Your vet & insurance
About your cat
Behaviour & health
Home & household
Litter habits & learning
Personality & handling
Routine & diet
Other cats
Permissions & final details

Your details

Whoever spends the most time with your cat should fill in this form. Discuss your answers with your household and mention any differences of opinion.

If it’s safe to film, send clips of the behaviour that concerns you and of your cat behaving normally via WhatsApp on 07594 324106.

First name

Last name

Phone Number

Address line 1

Address line 2

Town or city

County

Postcode

Country

What previous experience do you have with cats?

Veterinary care and insurance

Do you give us consent to contact your Veterinary Practice for referral and access to all veterinary records for the above named pet? Please note, that we only work on veterinary referral which includes review of veterinary notes for your pet.

Yes

Which Veterinary Practice is your cat registered at?

Address for Veterinary Practice where your pet is registered

Is your cat insured

Yes

If Yes, and your insurance covers for behaviour problems and you would like to do a direct claim*, please let us know the following.

Insurance Company:

Policy Number:

Excess payment:

Date problem first noticed:

* Please note that a Direct Claim is where you pay us your excess and we claim the rest of the fee back from your insurance company. By filling in the details above, you agree to raising the claim with your insurance company and/or give us permission to contact your insurance company to make a direct claim on your behalf and also agree to paying us the balance within a set time frame should they decline the claim for any reason.

About your cat

Name:

Breed (if cross, indicate predominant breed or type if known):

Sex (please mark the appropriate boxes):

Male

Female

Neutered

Date last wormed:

Date of birth:

Age when obtained:

Source:

Please indicate age of weaning if known:

Details of early life, if known, including litter size, early illness, rehoming etc

How long did it take to housetrain your cat?

Behaviour concerns

If you have any video footage of the behaviour or it is safe to gather some, please include this with your questionnaire, or bring with you to the consultation..

Please describe in a few words, the nature of the problem causing concern? If there is more than one problem please number them in order of importance (no. 1 = most important)

When did it begin?

Where does it occur?

With whom?

How frequently does the problem occur? (times per day, per week)

What has been done to correct the problem? Please indicate whether each measure has helped, made no difference or made matters worse

Is the problem getting

Better

Worse

No change

Do you suspect any cause?

In an ideal world what would you hope to achieve with your cat?

Is your pet currently on any medications or supplements etc. (such as dietary supplements or herbal products)? If yes, please list name and dosage.

Known medical history (especially recurrent problems):

Your home

Type of home (i.e. flat, house, etc):

Degree of access by cat (ie. Can go in all rooms, not allowed in bedroom, etc):

Do you have a garden that the cat can see through the window?

Does your cat have access to the garden?

Yes

If yes, is this access: Controlled Free or through a cat flap?

Please list other household pets, names, species, ages, gender and whether they are spayed or neutered:

Name | Species | Age | Gender / Neutered

Please list names and ages of other family members who live at home and how you would describe the relationship of each family member with your cat:

Name | Age | Relationship with cat

Litter box arrangements

Do you have a litter box?

Yes

If yes, how many?

What type (covered, uncovered, shape, size)?

Where are the litter boxes in the home?

How often is the litter box cleared of excrement and topped up with fresh litter as necessary?

How often is it completely cleaned out (i.e. washed and all litter replaced)?

Your cat’s early history and development

How do you correct your cat when s/he misbehaves?

How do you reward you cat when s/he has done well?

Your cat’s temperament and personality

How would you describe your cat’s personality?

Does your cat have any known fears or things it dislikes?

When does your cat:

Meow

Growl

Purr

Other

What is your cat’s favourite pastime?

Does your cat tolerate, enjoy or resist the following (please tick the appropriate boxes):

Handling

Tolerate

Enjoy

Resist

Grooming

Tolerate

Enjoy

Resist

Does your cat groom itself a lot?

Yes

If yes, where and indicate if this is at any particular time?

Does your cat treat all members of the household in the same? Please give details of any differences.

Your cat’s routine

Describe a typical 24 hours in your cat’s life

Where does your cat sleep?

What arrangements are made for the cat if you are away from home for an extended time, e.g. on a holiday?

Does your cat have a scratch post?

Yes

Does your cat show any sexual behaviour, normal or unusual?

Diet

Feed type – wet / dry:

Food provision - ad lib, or how many meals per day:

If your cat is fed meals, does your cat tend to eat it all at a single sitting?

Yes

How would you describe your cat’s appetite:

Please list any supplements, treats or titbits which your cat receives:

Multi-cat households only

If you have more than one cat, please provide the following details:

Please describe how / where all cats are fed e.g. separate bowls in different rooms, one communal bowl etc.

How many water bowls do you have and where are they located:

How many beds or sleeping areas are there in your house? Please describe them and their locations:

Please give details of which cats, if any, will share sleeping areas with each other:

How would you describe the relationship between the individual cats in your home? Please give details of which cats, if any, will groom each other or which cats avoid each other, for example.

Do your cats play together? Which ones? Who initiates play, or who chases who when playing?

Do any of your cats hiss at each other? Which ones?

Optional permissions

Please indicate if you are happy for individuals from the Pet Behaviour Company to use your animals case details (anonymised) for educational and/or marketing purposes? E.g. to be used as a case discussion with other professionals/students working within the field.

Yes

We support students and those working towards professional recognition within the training and behaviour field. With this in mind, please indicate if you are happy for us to record your initial consultation so it can be observed and used for educational purposes for those working towards professional recognition.

Yes

Further to the above, please indicate if you would be happy to have a student who is working alongside the Pet Behaviour Company sit in and observe your initial consultation (this is for educational purposes by those working towards professional recognition).

Yes

Additional information