Feline Behavior History Form

Animal Behavior Consultants of Northern Michigan
Dr. Katherine A. Houpt
Phone: (989) 448-8083
web: http://abcofnm.com
email: kah@abcofnm.com

Please answer the following questions and submit this form. We shall then call to arrange an appointment. Specific questions about the problem behavior(s) will be asked during your visit/telephone call.

General Information

Who is your regular veterinarian:

Behavior Problem


  1. Behavior ProblemSeverity
  2. Describe several examples in detail: When, where and what other animals or people were present.
    1. ( )
    2. ( )
    3. ( )

Elimination Behavior

    1. ( )

Cat's Background









Diet and Feeding

Home Environment








Daily Schedule


Social Behavior





Sexual Behavior

Grooming

  1. ?

Medical History

Seriousness






(End of questionnaire, please submit - thank you!)