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.
Sorry, something has gone wrong with the form.
Please read and agree to the attached Waiver, Informed Consent and Policies PDF (click below).
CCinc Waiver March 2023.pdf
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
Would you like to be added to our Newsletter list?
No/yes
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?
*
I have read and agree to the terms above
Clear
Sign Here
Please sign using the space above.
Submit
Please enter all required fields above.
