ARLINGTON CAT CLINIC – Inappropriate elimination

1

Today's Date

Owner's Name

Last Name

Patient Name

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2

Email

Is your cat having

Outside the litterbox?

When did the problem start?

Is it getting

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3

How often does the problem occur?

When urinating outside the box does your cat

How many litter pans are available?

Locations

Are the boxes covered or uncovered

What brand of litter is used?

Do you add

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4

Before this problem started were there any changes in

Litter

Location of the box

Type of litter-box

Other changes(pets, people, redecorating, new residence)

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5

Where do the accidents occur?

Does the cat have a preference for going on certain surfaces?

If other, Please Specify

What have you used to clean the areas?

Has your cat had a bad experience near the litter-box?

If so, please explain

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6

What do you do as punishment, if any?

What methods have you tried for the problem?

Have they helped?

Is the cat currently on medication (specify medicine)

Have you noticed any abnormalities to the urine or stool?( blood, mucus, loose stool)

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