Geriatric Behavioral History

Welcome to the Forms page of Marlborough Veterinary Clinic. To ensure that we provide the best possible care for your pet, we ask all clients to complete the relevant forms prior to their visit. Each form is designed to gather specific information tailored to different types of animals and medical needs.

Completing this form in advance will help streamline your visit, ensuring our team has all the essential details to provide comprehensive and personalized care for your pet. Please fill it out to the best of your ability, and either submit it online or bring it with you to your appointment. If you have any questions about which form to complete, please don’t hesitate to contact us. We look forward to meeting you and your pet!

Does your pet demonstrate destructive behaviors? Please describe behavior/ when first observed.

A. Do these behaviors occur in your presence or only when you are gone?

B. Is the damage concentrated at “exit points”? (Doors, windows etc.)

C. Do these behaviors correlate with noises or events which make your pet anxious (i.e. Thunderstorms)?

D. Have any of these behaviors occurred concurrently with a change in the house hold (addition or loss of people/pets, recent move etc.)?

Does your pet demonstrate elimination behavior problems? (Loss of house training, incontinence, eliminating outside litter box (cats), urine “marking”, etc.) Please describe the behavior, when first observed, and frequency.

A. Do these “accidents occur in your presence?

B. Is the urine/stool abnormal in appearance?

C. Does the pet appear to be aware of voiding, or does the act seem to be unconscious?

Does your pet bark or otherwise vocalize excessively? Please describe the circumstances- (When kept alone, around feeding time, anxiety, storms etc.)

Does your pet show aggression toward you or other family members/strangers/other animals? Please carefully describe the circumstances.

Does your pet demonstrate disturbances in sleep/ wake routines such as nighttime restlessness, hyperactivity, etc.? Please describe behavior and when first observed.

Does your pet fail to recognize previously familiar people or commands, or seem disoriented? Is the problem consistent or occasional?

Does your pet exhibit any repetitive or compulsive behaviors (circling, licking a specific area of body, etc.)

Please describe any other behaviors not covered above that you feel are abnormal or which are a recent development.

In what hours of the day is your pet in the house or yard?

A. During the day?

B. During the night?

C. When are they left alone? How long?

Geriatric Behavioral History

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