Feline Assessment Form First & last name(required) Email(required) Phone number(required) Address(required) Cats name(required) Age(required) Breed(required) Sex(required) Male Female Neutered male Spayed female When and at what age did you acquire your cat?(required) Where did you get your cat?(required) What other pets live with your cat?(required) What other humans live with your cat?(required) Current veterinarian(required) Last veterinary exam(required) Do you consent that I contact your veterinarian for medical records?(required) Yes No Medical concerns(required) Current medications & supplements(required) Food sensitivities(required) How is your cat at the veterinary hospital?(required) Does your cat need assistance with husbandry or foundation behaviours?(required) Nail trimming Ear cleaning Body handling & restraint Brushing teeth Blood collection Medication administration Veterinary exam Getting into a carrier Grooming Stationing None at this time Other Does your cat eliminate outside the box? If yes, is it urine and feces? How often? How many litterboxes do you have? How big are the litterboxes? Where are the litterboxes located? Behavioural concerns(required) What do you feel is the function of the behaviour(s) mentioned above?(required) What have you tried so far?(required) Did it make the behaviour better or worse?(required) Has your cat ever shown aggressive behaviour? If yes describe the events.(required) How long is your cat home alone for?(required) Does your cat exhibit any behaviour problems when you leave him/her alone?(required) Anything else you'd like me to know? Submit Δ