Pet Home-Alone Behavior Survey Form
Please complete this Pet Home-Alone Behavior Survey Form to help us understand how your pet behaves when left alone.
Your Name
*
First Name
Last Name
Pet's Name
*
Pet Type
*
Please Select
Dog
Cat
Bird
Small Mammal
Reptile
Other
Pet's Age
*
How often is your pet left home alone?
*
Daily
Several times a week
Once a week
Rarely
What is the typical duration your pet is left alone?
*
Less than 1 hour
1–3 hours
3–6 hours
More than 6 hours
Which behaviors does your pet display when left alone? (Select all that apply)
*
Calm/resting
Vocalizing (barking, meowing, etc.)
Destructive behavior (chewing, scratching, etc.)
Pacing or restlessness
House soiling
Attempts to escape
Other
How intense are these behaviors when your pet is left alone?
*
Not at all
1
2
3
4
Very intense
5
1 is Not at all, 5 is Very intense
What triggers or situations seem to affect your pet’s behavior when alone? (Select all that apply)
*
Departure cues (e.g., picking up keys)
Time of day
Noises outside
Other animals
Unknown/unsure
Other
What coping methods or interventions have you tried?
*
Leaving toys or treats
Background music/TV
Crate or safe space
Medication or supplements
Training/behavior modification
Other
Additional notes or observations (optional)
Submit Survey
Should be Empty: