Litterbox questionnaire

Primary handler's name *

The person most responsible for the training

First Name

Last Name

Primary handler's cell phone number *

(###)

###

####

Secondary handler's name

Another person who needs to be in the loop

First Name

Last Name

Secondary handler's cell phone number

Will be included in group texts between the trainer and primary handler

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender *

Female

Male

Spayed/Neutered? *

YES

NO

Is your cat urinating outside the litterbox?

Exclusively

No

Sometimes

Is your cat defecating outside the litterbox?

Exclusively

No

Sometimes

Is your cat using the litterbox at all?

Sometimes to urinate

Sometimes to defecate

Only to urinate

Only to defecate

Never uses the box

If you have multiple boxes, does your cat use one and not others?

Yes

No

Do you allow your cat outside?

Yes

No

Sometimes

Have you seen your cat urinate outside?

Yes

No

Have you seen your cat defecate outside?

Yes

No