Feline Harmony Initial Questionnaire ========== Where there are multiple choices (Y/N or choices each beginning with -), please delete all that do not apply, and leave only the ones that you would check or circle on a printed copy. ========== General Information Name: Address: Phone: Home Work Other Email: Vet / Clinic: Vet Phone: Referred by: ========== Your Cat Name: Breed: Colour: Date of Birth: Weight: Sex: F M Spayed/Neutered? Y N Age Spayed/Neutered: Declawed? Y N Age Declawed: Why? How long has your cat been with you? Where did you get him/her from? Why did you get your cat? (companionship, breeding, etc) Briefly describe your cat's personality: (eg, friendly, playful, distant, curious, independent, timid, gentle, dominant) Does your cat have any ongoing or recurring health issues? Please explain. Are you aware of any highly stressful events in your cat's life previously? Please explain. (eg, abuse, homelessness, surrender to a shelter or abandonment by previous owner, living with an aggressive animal) ========== Family and Home Environment Please list all human family / household members below, including yourself. Name, Sex, Age, How do they get along with your cat? 1 2 3 4 5 Who feeds your cat? Who cleans the litterbox? Briefly describe your household schedule, including how much time your cat is alone. Any special notes? Please list all other cats in the family / household. Specify if spayed/neutered. Name, Sex, Age, How do they get along with your cat? 1 2 3 4 Any special notes? Please list all other pets in the family / household. Name, Type/Breed/Sex/Age, How do they get along with your cat? 1 2 3 4 Any special notes? Does your cat go outside? Y N - Loose - Harness/leash - Enclosure - Balcony How often? Briefly describe your home, including limits on areas your cat has access to: (size/rooms, house, apartment, city, country, yard, balcony) ========== Lifestyle What does your cat eat? What time? Does your cat get treats? Y N What kind? How often? What are your cat's eating habits? (eg, fussy, bolts food without chewing, will only eat under specific conditions) Where does your cat normally eat? Does your cat get catnip? Y N How often? Reaction? Does your cat hunt? Y N What prey? What does she/he do with it? What are your cat's favourite toys and games alone? What are your cat's favourite toys and games with others? Who plays with your cat? How often and how long? Does your cat have access to: - Climbing structure - Scratching post - High perches - Private den/nest - Windowsills/perches Does your cat make use of: - Climbing structure - Scratching post - High perches - Private den/nest - Windowsills/perches How long is your cat alone on a normal day? How does your cat react to being alone? Where does your cat stay or sleep during/when... Daytime (alone): Daytime (not alone): Night-time: Known guests visit: Strangers visit: Does your cat self-groom: - A normal amount - Not much - With difficulty due to weight/health - Excessively Does your cat groom: - Other family cats - Family humans - Family pets - Inanimate objects Does your cat scratch on inappropriate targets (eg, furniture)? Y N Sometimes How often? Do you consider this a problem? N Minor Major What does he/she scratch on? Do any situations or events cause grooming or scratching to increase/decrease? Has this ever become a problem? How many litter boxes of each type do you have in your home? Standard/open Covered Self-cleaning Kitten-sized Other (describe) _____________________________ Does your cat reliably use the litter box for: Urine (pee)? Y N Sometimes Stools (bowel movements)? Y N Sometimes What kind of litter do you use? How often is the litter scooped or changed? How often is the box cleaned/washed? What do you use to wash the box? Does your cat ever housesoil, i.e., use inappropriate places for elimination? Y N How often? - Urine on vertical surfaces (walls, against furniture) - Urine on horizontal surfaces (floors) - Stools If you have multiple cats, do they share the litter boxes? - Share - Each uses a different one - Only one box ========== How Does Your Cat React To... Car rides: Loud/unusual noises: Unfamiliar humans: Unfamiliar cats: Unfamiliar dogs: Unfamilar places: New furniture/objects in environment (except toys): Nail trimming/claw clipping: Being restrained in lap: Grooming/brushing: Getting pills: Getting liquid medication (by mouth): Cleaning/treating ears: Being picked up/carried: Stroking/petting: Being bathed: Harness/leash: Cat carrier/kennel: ========== Behaviour Modification What would your cat's top five rewards be? (eg, specific treats, toys, attention, catnip) If you punish your cat, how? How does your cat react to it? (eg, water spray, confinement, noise) Have you tried any kind of deterrent to change your cat's behaviour? What was it, and how successful was it? (eg, scented sprays, double-sided tape) Have you tried any punishment/deterrent that had a negative effect (made things worse)? What was it, and what was the result? Have you ever tried to train your cat? How did you do it, and what was the result? Does your cat tend to learn quickly? Does your cat know any “tricks”? Does your cat respond best to specific people? Who? Does your cat respond poorly to specific people? Who? ========== Aggression and Fear Does your cat ever act aggressive? Y N Towards: - Human family members - Other humans - Other cats in home - Unfamiliar cats - Other pets in home - Unfamiliar animals - Other: Please describe circumstances and what your cat does: What do you do when this happens? How does your cat react to this? Is your cat fearful, timid, shy, or anxious? Y N Is this: - Mild - Moderate - Severe Please describe circumstances and what your cat does: What do you do when this happens? How does your cat react to this? ========== Comments Does your cat have any other behaviours, personality traits, or concerns you'd like to mention that haven't been covered, other than the primary issue?