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Home » Cat Owner Questionnaire

Cat Owner Questionnaire

Your name(Required)

First

Last

Date(Required)

MM slash DD slash YYYY

Spouse, partner or roommate:

Children and ages:

Cat’s name, age, sex and breed:

How does your cat interact with family members?

Friendly

Aggressive

Nervous

Avoids contact

Who is your cat’s favorite person:

How does your cat interact with strangers?

Friendly

Aggressive

Nervous

Avoids contact

Name and age of other cats. Please label the order they arrived into the house:

Other pets (species, breeds and ages):

If you have other cats or pets in the household, have you recently seen your cat responding to them in any of the following ways?

Playing together

Sleeping together

Mutual grooming

Being aggressive (eg, hissing, growling, swiping)

Running away

Please describe

How do you think your pets get along?

Does your cat go outside?

Yes

Occasionally sneaks out

Goes outside supervised

Goes outside unsupervised

Has pen or outside enclosure

Do you have a cat door or flap to the outdoors?

Yes

Type:

Can your cat see other animals from inside your home?

Yes

If yes, describe (ie, cats, birds at feeder, etc)

What type of food do you feed your cat?

Canned food

Dry food

Have you changed the food recently?

How many litter boxes are in your home?

Open

Hooded or covered

Automatic

Liners

Deodorizers

Average size in cm or inches

Who scoops the litter box?

How often:

Twice daily

Daily

Weekly

Other

Type of litter used:

Fine grain (clumping)

Non-clumping clay

Coarse granules

Wood or paper-based pellets

Scented

Silica granules or beads

Corn- or wheat-based

Garden soil

Other

How often do you wash the litter box and what cleaning products do you use?

If your cat urinates when house-soiling, how would you describe the urine?

Normal

Large volume

Small volume

Strong odor

Sticky consistency

Bloody

Passed more/less frequently than usual

If your cat defecates when house-soiling, how would you describe the stools?

Normal

Small and hard

Soft and watery

Blood/mucus

Formed in part, then softer

Other

How long has the house-soiling been occurring?

Do you remember the first incident?

Yes

If yes, please describe:

What kind of surface is targeted?

Carpet

Wood

Vinyl

Tile

Bedding/clothing

Bath/shower/sink/basin

A particular family member

Other

A particular family member

Other

Is the cat targeting vertical surfaces with urine?

Yes

If yes, what volume is being passed?

How often is the house-soiling soiling occurring?

Once daily

Multiple times daily

Weekly

Other

How has the frequency changed since the problem started?

Increased

Decreased

Remained the same

Don’t know

Have there been any changes recently (or around when the house-soiling started)?

Moved to new home

New baby or pet

Absence of family member/pet

Other

Please detail what you have been doing to clean the soiled areas

Have you used any physical punishment in response to the house-soiling (eg, rubbing nose in the urine or stool, spanking, water pistol, shouting, confinement)?

Yes

Please describe

Is your cat easy to medicate?

Yes

What are your preferred formulations for any medications?

Pills

Medication in food

Oral liquids

Transdermal gel (where available)

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1
Call us or schedule an appointment online.
2
Meet with a doctor for an initial exam.
3
Put a plan together for your pet.

Make An Appointment

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Make an appointment

614-360-3941

1117 W 1st Ave,
Columbus, OH 43212

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Our Hospital
Services
Pet Health
New Clients
- New Client Form
- Payment Options
Contact Us
- Request A Refill
- Emergency
Make An Appointment
Online Pharmacy

Monday

8:00am - 7:00pm

Tuesday

8:00am - 7:00pm

Wednesday

8:00am - 7:00pm, Closed 12:30-2:30pm

Thursday

8:00am - 7:00pm

Friday

8:00am - 6:00pm

Saturday

8:00am - 1:00pm

Sunday

Closed

We are open on alternate Saturdays. For more information, Please call us at 614-360-3941.

Cat Owner Questionnaire

What's Next

Call us or schedule an appointment online.

Meet with a doctor for an initial exam.

Put a plan together for your pet.

Where family pets find loving care