Feline History Form

Please answer the following questions below. Detailed information is critical for Dr. Rigterink to diagnose and recommend a treatment program. This form should be sent to Veterinary Behavior of Indiana at least 7 days prior to your appointment.

If you would prefer to download and fill out the form at home, please click here. Please then submit your completed form to info@indianavetbehavior.com.

Behavior Problem
Cat's Background
Chronology of the Behavior Problem
Elimination Behavior
What types of pans (indicate number)?
Diet and Feeding
Home Environment
Social Behavior
Medical History
Click or drag a file to this area to upload.

Please note: Your behavior history form was uploaded to the Veterinary Behavior of Indiana's email address once you get a confirmation page with a picture of a large dog.