Full Life Cat Behavior Questionnaire

Please type your responses in detail and return the completed questionnaire within 48 hours of your first appointment to FullLifeBehavior@gmail.com.


Sign in to Google to save your progress. Learn more
Owners Name: *

Phone

 *
Email *
Adress(optional):

Cat's name: 


 *

From: (Name of breeder, rescue, shelter, or rehomed)

 *

Male or Female:

 *

Approximate age:


 *

Spayed/neutered:    

 *

Declawed:

 *

Length of time in your home:


 *

Allowed outdoors?:

 *
Veterinarian Name and Veterinarian Practice: *

How did you find my services?:

 *

Known medical history (both in and before your home):

 *

Known behavior history (before your home):

 *

Behaviors observed in your home, good and bad:

 *

Previous training experience: including what you have done to help adjust the behavior:


 *

Description of your household: members (including ages of children), energy level of the home and neighborhood:


 *

Average daily routine: including exercise, sleep schedule, and food (brand and main ingredients):

 *

Your cat’s favorite toys, activities, and treats:

 *

Goals for your cat:

 *
Additional Litter Box Issues
write (N/A) if it does not apply.

Does your cat potty in specific locations or on certain materials?


 *

How often does this behavior occur?

 *

What cleaning products have you tried?


 *

How many litter boxes are in the home?

 *

Where are the litter boxes located?

 *

Does the cat use any of the litter boxes?

 *

Type of Litter (brand, scented/unscented, substrate):

 *

How often do you change brands of litter?

 *

Type and description of the litter boxes:

 *

How often do you scoop each box?

 *

Do you use box liners?

 *

How often do you deep clean the boxes?

 *

Does your cat cover the waste in the box?

 *

Does your cat scratch outside of the box?

 *

Does your cat straddle the box?

 *

Does your cat bolt/rush out of the box once finished?

 *

Private Training Service Contract and Policies

LIABILITY WAIVER & POLICIES

1. Alisha K. Fritz, Full Life Behavior & Training, LLC will endeavor to create as safe an environment as possible for the training of my cat and will offer only sound, safe, and responsible training, and training instructions.  However, to the extent that Alisha K. Fritz, Full Life Behavior & Training, LLC is insured for any unintentional or negligent errors, omissions, or incorrect assertions, Alisha K. Fritz, Full Life Behavior & Training, LLC will be responsible for any such acts or omissions, but only to the extent of such insurance.  I have been told by Alisha K. Fritz, Full Life Behavior & Training, LLC and understand the inherent risks of owning a cat, including but not limited to the risk of cat bites and/or scratches to myself or others, and consequently I am and will remain responsible for the actions of my cat at all times, and I hereby agree to indemnify and hold harmless Alisha K. Fritz, Full Life Behavior & Training, LLC of any and all claims of injury, expense, costs, or damages caused by my cat.  I understand that the recommendation of any other product or service is not a guarantee of my satisfaction with that product or service.                                                                                                       

Initial:           

 *

LIABILITY WAIVER & POLICIES

2. Payment Policy:  All payment is due upon booking of services.  Payment may be made by credit/debit card, cash, or check.  I will receive an invoice and receipt for all transactions.

Initial: 

 *

LIABILITY WAIVER & POLICIES

3. Cancellation Policy:  A cancellation by cat guardian must be made 24 hours prior to an appointment time or may not be rescheduled.  No refunds will be given for unused sessions. 

Initial:           

 *

GENERAL “HOLD HARMLESS” AGREEMENT & “LIABILITY RELEASE” for Alisha K. Fritz, CBCC-KA and Full Life Behavior & Training, LLC.

RESPONSIBILITY & LIABILITY: 

I feel confident that Alisha K. Fritz will make every effort to provide a safe environment for all feline and human clients under her instruction as well as others within the general proximity of her work.  I agree to place and/or leave my cat with Alisha K. Fritz at my own risk.  I have researched the skills and credentials of Alisha K. Fritz and agree with all associated handling practices, policies and procedures.  I understand that all cats can and do bite and scratch; and I am aware of (1) the risk of injury to myself or my cat(s) while in training and (2) that I am responsible for any injury, or physical or financial damages caused by my pet(s) to another pet, person or the physical location in which training is conducted.  I will not hold Alisha K. Fritz, or Full Life Behavior, LLC. designated agents/associates, outside of gross negligence, responsible should an accident, injury, illness, escape, theft, fire, or death of my pet occur while in their care.

MEDICAL TREATMENT: 

In my absence, I give permission to Alisha K. Fritz to act on my behalf in case of emergency or apparent health related issues.  I also give permission for my pet to be transported by car to (1) my personal veterinarian, (2) Alisha K. Fritz’s vet of choice, or (3) Emergency Animal Clinic for any situation that medical assistance is needed while my pet is in the care of Alisha K. Fritz.  I agree to reimburse Alisha K. Fritz for any and all charges incurred for medical treatment of my pet.  I will not seek retribution from Alisha K. Fritz should an accident, injury, illness, escape, theft, fire, or death of my pet occur during or following any services rendered by Alisha K. Fritz or Full Life Behavior & Training, LLC. designated agents or associates. 

VACCINATIONS/OVERALL HEALTH: 

I hereby declare that my pet is current within the calendar year on vaccinations.  I understand it is my responsibility to keep my pets regularly vaccinated and to provide updated records to Alisha K. Fritz upon request and that my cat can be refused for services should I fail to do so.  I also understand that my cat is still susceptible to other illnesses due to age, stress, nutrition levels, immune system, and exposure to other cats.  I understand that Alisha K. Fritz requires all cats in training to be clean, healthy, and vaccinated with no apparent fleas, ticks, worms, etc.

MISCELLANEOUS DETAILS: 

(1) I understand that Alisha K. Fritz is not responsible for misplaced, lost, damaged or broken items during or following any services rendered. 

(2) I understand the rates and payment terms for services rendered by Alisha K. Fritz.

(3) I understand if I am not satisfied with the services provided by Alisha K. Fritz that I agree to notify her of such by close of business the following day and that refund is not guaranteed.

(4) I understand Alisha K. Fritz has the right to refuse service to any owner and or pet at her discretion. 

(5) I understand that Alisha K. Fritz will not release my pet to anyone without my consent. 

RIGHTS TO PHOTOGRAPHS & VIDEO FOOTAGE 

I authorize Alisha K. Fritz the right and permission to use any photographs/video taken of my cat for any purpose and in any media now or in the future. Online sessions are often recorded and are available to clients upon request.

I CERTIFY THAT I HAVE READ AND UNDERSTAND ALL OF THE CONDITIONS AND STATEMENTS CONTAINED WITHIN THIS AGREEMENT. 


 *

This contract is validated by the signatures below in total and as approval for future services without additional written authorization.

Cat Guardian
Name:      Date (mm/dd/yyyy):
 *
Cat Guardian Signature *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms