We provide dog training, behavior consulting, dog sport, daycare and in home boarding services. Our staff are certified or working under the supervision of certified trainer.
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Cat Behavior Consult Intake Form
Please read and agree to the attached Waiver, Informed Consent and Policies PDF (click here):
Current - CCinc Waiver Sep 2023.docx
You and Your Household
Please provide the following information to help us serve you better.
Name
*
Email
*
Address
*
-- Country --
Australia
Canada
United Kingdom
USA
Phone
*
-- Country Code --
+1 - Canada
+1 - USA
+61 - Australia
+44 - United Kingdom
Other Phone
How did you hear about us?
*
Drive By
Facebook
Other Social Media
Google
Other Search Engine
Family/Friend/Neighbor
Groomer
Newsletter
Rescue Group
Other Courteous Canine Inc. Clients
Rescue Group
Veterinarian
Other
Training Information
Location Preference
*
In Home
Virtual
Preferred time of day and day of week for your training session, please check all that apply:
*
During the day during the week
During the evening during the week
On the weekend
Select your home type
*
House with fenced in yard
House with yard - no fenced
House with no yard
Apartment/Condo - no yard
Other
Other home type:
My experience with cats is:
*
Cat breeds I have parented:
*
How busy is your home:
*
Very busy - visitors every day
Moderately busy - visitors several times a week
Mildly busy - visitors once a week
Quiet – very rarely have visitors
In addition to you, list the names and ages of all people and animals in the household, including yourself:
*
Do any of these animals fight with each other?
*
Yes
No
N/A
If yes, please elaborate:
Primary Cat Name:
*
Date of Birth:
*
Sex
*
-- Select One --
Male
Female
Spayed or Neutered
*
Yes
No
Unknown
Breed
*
Weight
*
Is your cat microchipped?
*
No/yes
Age when Spayed or Neutered?
*
Pediatric
6 months
Adult
Unknown
1. What is the main problem behavior or complaint?
*
2. Are there other behavior problems?
*
No/yes
If yes, please explain:
3. When did you first notice the problem?
*
4. What general circumstances does the cat misbehave? What are the triggers?
*
a. Stress
b. Interhousehold conflict with another animal
c. Interhousehold conflict with a person
d. Environmental changes
Comment box to elaborate on your answer:
5. What should the goal of training be:
*
6. Has this cat had previous training?
*
No/yes
7. If yes, with whom and on what behaviors and explain methods used:
8. Is the problem behavior getting better, worse or staying the same?
*
Better
Worse
Same
Other
Other (please explain):
9. What have you done to try to fix the problem?
*
10. What is the possible outcome if this behavior is not resolved:
*
Rehome
Surrender
Return to Breeder
Human Euthanasia
Committed to cat for life
11. Where did you get this cat?
*
12. How old was the cat when you got him/her?
*
13. Has this cat had other parents?
*
Yes
No
Unkown
14. Rate your bond with this cat: (0 no bond up to 10 maximum bond)
*
15. If the problem were resolved would the bond number go up?
*
No/yes
16. What do you feed your cat?
*
17. Is your cat’s food down all the time or do they eat on a schedule:
*
Feeding Schedule
Food down all the time
18. Does your cat finish their meals within 10 minutes of when you feed them?
*
No/yes
19. Does your cat ever miss meals?
*
No/yes
20. Does your cat groom regularly?
*
No/yes
21. What is your cat’s relationship to the other people and animals in the household (friendly, hostile, fearful)? Please describe.
*
22. How is your cat when they are left alone?
*
a. Parent absent vocalizations?
b. Parent absent destructive behavior?
c. Parent absent urination or defecation outside of litter box?
If box c is checked: Urine/feces/both?
Urine
Feces
Both
How many litter boxes?
How often are they cleaned?
Has the cat seen a vet about the litter box problem?
No/yes
23. How is your cat during thunderstorms or fireworks:
*
No issues
Mild noise issues
Moderate noise issues
Severe noise issues
If noise issues, then how do they react?
24. Has your cat ever shown aggression toward you:
*
No/yes
If yes, please explain:
25. Does your cat resource guard:
*
You
Toys
Food
Other household members
Other
Other (please explain):
26. How is your cat with strangers?
*
Happy to see them
Fearful
Angry
Bites
Scratches
Unknown
Other
Other (please explain):
27. How do you mentally stimulate your cat?
*
28. How do you physically stimulate your cat?
*
29. Length per day of mental stimulation (min per day or week):
*
30. Length per day of physical stimulation (min per day or week):
*
31. Does your cat have medical conditions:
*
No/yes
If yes, please explain:
32. Please list any medication your cat takes:
*
33. What do your cat’s stools look like:
*
normal well-formed
loose pudding
loose like water
34. Where does your cat sleep:
*
35. How many hours does your cat sleep:
*
36. Does your cat wake you at night?
*
No/yes
If yes, please explain:
37. How well does your cat relax in your home when there is no activity?
*
Well-relaxes or sleeps most of the day
Has a hard time sitting most of the time
Paces sporadically
Paces constantly
Wants to play constantly
Other
Other (please explain):
38. If you use a groomer, please explain if there are problems with the groomer:
39. If you use boarding, please explain if there are problems with boarding:
40. If you use a pet sitter, please explain if there are problems:
41. How is your cat when you have guests:
*
Ok
Reserved
Happy to see them
Fearful
Hisses
Has to be put up
Other
Other (please explain):
42. How is your cat with children:
*
Ok
Reserved
Happy to see them
Fearful
Hisses
Has to be put up
Other
Other (please explain):
43. How is your cat at the vet:
*
Ok
Reserved
Freezes
Afraid
Shuts down
Very happy and excited
Has to be sedated
Has to be muzzled
Other
Other (please explain):
44. Does your cat have any problems being handled:
*
No/yes
If yes, please explain:
45. What are your cats three favorite foods?
*
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