Cat & Kitten Behavior Profile
This survey form is for confirmed clients with pending appointments. 

Please fill this survey out before your scheduled session. If you have not yet contacted me for a session, please do so first before taking the time to fill this out. If your contact information is missing or incorrect, I will not be able to email you back! Double check for accuracy. Behavior issues & concerns that involve more than one pet species, please use separate Dog/Puppy form. Your initial consultation fee includes assessment of information on this form. Thank you! -Rochelle (she/her)
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Your Name & pronouns *
Please list your email address so I can contact you to discuss your submission.  *
Your cat's Name, Age, & breed(s). If unknown breed, please indicate size of cat and indicate long hair/medium/short hair *
Household members Names & Age range. Exact age not required. (Infant, child, pre-teen, teen, young adult, adult, senior); include any other household pets or pets/family who visit frequently *
Rate your experience level with pet guardianship *
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First time pet owner
Very experienced/advanced training knowledge
Is your cat spayed or neutered? *
Describe your pet's normal daily routine and feeding schedule. Play schedule (if any)? Where does your cat sleep at night? Type of food (kibble, wet, fresh/raw) and brand of food is helpful. If routine varies, give example of each day (ex. weekend schedule vs. weekday) *
List behavior concerns you are experiencing with your cat or why you are scheduling this appointment.  *
What type of litter box and brand of litter do currently use? Have you switched litter in the past 3 months? if so, Why? *
How many boxes are available to your cat(s)? Where are your litter box(es) located? On average, how often are the boxes scooped? *
Any previous or current medical concerns / diagnoses that I should be aware of?  *
Where does your cat spend their time? *
Does your cat have a bite history? *
Required
Have you talked to your veterinarian about your cat's behavior issue(s)? *
Has your cat had any surgeries or medical procedures that you know about? (spay/neuter excluded)
Are you considering rehoming or surrendering your pet to a shelter due to behavioral issue(s)? *
When and where does the problem behavior start? What makes it stop? How do you respond when the problem behavior occurs? 
Please describe your training style or any training equipment you've tried, if any. Have these training interventions worked for you in the past? 
How long have you lived with your cat? When did behavior issue(s) begin? If this is a preventative or informational consult, please indicate your timeline for training new behaviors. *
Select any recent changes that have occurred (</=3mos. unless otherwise noted)
How did you acquire your cat? *
What are your training goals for your cat? (e.g. reliably come when called, housetraining, resolve pet to pet aggressive issues, resolve biting/mouthiness, resolve reactivity/fearfulness, Harness training/ leash walking, ESA training, resolve separation related behavior issues, advanced task/goal based coaching) *
Anything else I should know? My goal is to make training fun and accessible for all. Please notify me of any mobility concerns, food allergies (for humans or pets), special circumstances, or special needs you or your pet may have and I will accommodate you to the best of my ability.
How did you hear about Roach the Pet Coach? Please mention your referrals name so I can thank them.
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