Feline Health Survey - Sherrills Ford Animal Hospital

Mixed breed

Gender

Male
Female

Spayed/neutered

Using a scale of 0-4, how would you describe your cat’s relationship with other members of the household?

ACCESS TO OUTDOOR ENVIRONMENT

What type of access does your cat have to the outside environment?

Through a screened window or door
On a leash or in a stroller/backpack
Supervised free-roaming within a fenced-in yard
Unsupervised free-roaming within a fenced-in yard
Supervised free-roaming
Unsupervised free-roaming
Enclosed patio/catio, porch, or balcony
Open-air patio, porch, or balcony
Other

Do you take your cat to any of the following?

Organized events or competitions
On airplanes
Boarding or grooming facilities
Public transportation (bus, taxi, train, subway)

Do you travel outside your home with your cat?

Does your cat hunt wildlife?

How often?

Every day
1x per week
Rarely

HOME ENVIRONMENT AND HOME CARE

Do you observe animals or other wildlife in your neighborhood?

Do you or your cat visit homes where there are pets?

Do other pets come to visit at your house?

Do children, elders, or people with weakened immune systems live in or visit your home?

Have you seen fleas, ticks, or worms on ANY of your pets in your home?

Have you noticed any fleas or ticks on your cat?

Which pets do you treat for fleas, ticks, internal parasites, or heartworms?

Every cat and dog in the household
Only the pets who go outside
Other

How often do you treat your pets for fleas, ticks, internal parasites, or heartworm?

In warmer months
Year-round
Sporadic
Other

LITTER BOX HABITS

Does your cat use a litterbox?

How often do you scoop them to remove urine and feces?

1-2x per day
1-3x per week
Not sure
Other

What type of litter do you use?

Clumping
Non-clumping

Scented?

Has your cat urinated somewhere in the house outside the litter box?

How often?

1x per day
1x week
Other

Has your cat defecated somewhere in the house outside the litter box?

How often?

1x per day
1x week
Other

YOUR CAT'S ROUTINE AND BEHAVIOR

How often does your cat eat?

Food is out all the time
1x per day
2x per day
3x per day

Out of what does your cat primarily eat?

Bowl or plate
Puzzle toy
Food dispenser
Other

Does your cat eat with other cats/pets?

Out of what does your cat primarily drink?

Bowl
Drinking fountain
Dripping faucet
Other

How often do you see your cat drink?

1x per hour
1x per day
Not sure

Do you brush your cat’s teeth?

Has your cat had their teeth scaled while awake?

Have you noticed a strong smell coming from your cat’s mouth?

Do you trim your cat’s nails?

Would you like help learning how to trim his or her nails at home?

What does your cat tend to scratch at home?

Scratching post
Carpet
Furniture
Other

Does your cat have any thinning spots on his or her hair coat?

If your cat vomits, what do you find in the vomit?

Hairball
Mucous
Food
Other

UNUSUAL BEHAVIOR

An increase in the amount of drinking or urinating?

Any weight loss or gain?

Any change in your cat’s skin or hair coat?

Any recent change in your cat’s activity level?

Any changes in ability or desire to jump up on tables, counters, or other high places?

Any limping or clumsy behavior?

Any coughing?

Any recent changes in your cat’s behavior toward you, other family members, other pets, or strangers?

Has your cat seemed “grumpy”, withdrawn, or started to shy away from physical touch and petting?