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House Soiling Questionnaire
Use this form if your cat is spraying, peeing or pooping outside of the litter box. Be sure to also submit the History & Behavior Questionnaire and the Training Agreement as well. Please be as descriptive in your answers as possible, as these questionnaires will help your trainer determine the best course of action for your kitty. Thank you!
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Indicates required field
Name:
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First
Last
Phone Number:
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Cat's Name:
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Age:
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Where does your cat eliminate?
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Indoors
Outdoors
Both
What type of litter boxes do you have? Be as descriptive as possible:
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examples: Covered, Hooded with a flap, high sides, low front entrance, clear plastic bin, automatic, etc
What brand of litter are you using?
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What type of litter is it?
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Clumping
Non-Clumping
Scented
Un-Scented
Clay
Pine
Walnut
Crystals
Newspaper
Pellets
Other
If other, please describe:
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Has this cat ever eliminated consistently in the litter box?
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When/how long?
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When does the elimination problem occur?
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Family Not Home
Family Home But Not Supervising
Family Sleeping/Night Time
With Family Watching
Is there a preference for secluded areas? (closets, under furniture, etc.)?
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Is there a particular room or area where the cat prefers to soil?
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Are there rooms or areas where the cat never soils, even though it has access to the areas?
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Surface preference(s) for soiling:
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Are there any surfaces on which your cat will not eliminate?
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Object preference for soiling (your belongings, new/old furniture, etc)?
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Does any straining or pain accompany urination? Defecation? Describe:
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Any blood in the urine? Stool? Describe:
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Are stools regular and normal consistency? If no, describe:
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Is there an increasing in drinking? If so, Describe:
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List 1) the most frequently soiled areas, 2) type of surface (carpet, bedspread, furniture, etc) and 3) how often your cat eliminates in each inappropriate location:
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Email:
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Breed(s):
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How many litter boxes do you have?
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Where is each box located?
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Describe the physical location of each box. Example: In the bathroom next to the toilet, in the bedroom in a closet, in the living room next to the front door, etc.
How often is the litter box scooped?
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How often is the old litter discarded and replaced?
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Is there a type of litter that the cat strongly likes or dislikes?
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Are there litter box locations that the cat strongly likes or dislikes?
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Do the cat’s use each other’s litter boxes?
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Does your cat dig/bury after eliminating?
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Age when litter trained:
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Method of training:
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Any problems training?
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What percent of all inappropriate elimination is urine?
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Stool?
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Frequency of urination outside the litter box each
Frequency of defecation outside the box:
Day
*
Day
*
Week
*
Week
*
Month
*
Month
*
Or
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Never Uses Box
Or
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Never Uses Box
Is there a preference for urinating on:
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Vertical surfaces (walls, sides of furniture, drapes)
Horizontal surfaces (floor, top of counters or furniture)
% Vertical
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% Horizontal
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Do other cats visit or mark outside your windows, doors, etc?
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If yes, does your cat’s elimination occur near these doors, windows, etc?
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Has your cat ever had a urinary problem? If yes, describe and indicate when:
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Any treatment?
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Current treatment (medication/diet)?
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Has your cat ever had a urinalysis? If yes, indicate when and outcome:
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# of Urinations/Day?
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Is there increased frequency of Urination?
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Yes
No
# Defecations/Day?
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Is there increased frequency of Defecation?
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Yes
No
Any additional comments?
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Submit
Home
Pet Services
Learn to Groom Pets
Cat Grooming
>
Cat Grooming Services
Why Groom Cats
Grooming FAQ
Request An Appointment
About Me
Blog
Store
Contact