Feline Health Survey

• Yes
• No

• Male
• Female

• Yes
• No

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

ACCESS TO OUTDOOR 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

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

• Yes
• No

• No
• Yes

• Every day
• 1x per week
• Rarely

HOME ENVIRONMENT AND HOME CARE

• Feral cats
• Squirrels, chipmunks, skunks, or small rodents
• Raccoons
• Deer
• Wild felines (bobcats, mountain lions)
• Wild canines (coyotes, foxes)
• Other

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

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

• In warmer months
• Year-round
• Sporadic
• Other

LITTER BOX HABITS

• Yes
• No

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

• Clumping
• Non-clumping

• Yes
• No

• Marble
• Golf ball
• Apple
• Grapefruit
• Other

• No
• Yes

• 1x per day
• 1x week
• Other

• Normal
• Strong odor
• Sticky
• Bloody
• Large volume
• Small volume

• No
• Yes

• 1x per day
• 1x week
• Other

• Normal
• Soft and watery
• Small and hard
• Bloody
• Slimy
• Other

YOUR CAT'S ROUTINE AND BEHAVIOR

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

• Bowl or plate
• Puzzle toy
• Food dispenser
• Other

• Yes
• No

• Bowl
• Drinking fountain
• Dripping faucet
• Other

• 1x per hour
• 1x per day
• Not sure

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Scratching post
• Carpet
• Furniture
• Other

• Yes
• No

• None
• 1x per day
• 1x per week
• 1x per month
• Other

• Hairball
• Mucous
• Food
• Other

UNUSUAL BEHAVIOR

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No