Animal hoarder Disorder
How many animals do you own?
5 or less
5 or more
10 or more
30 or more
unable to count number of animals
Was your home environment growing up chaotic?
yes
no
Were you neglected by your caregivers as a child?
yes
no
Were your caregivers verbally abusive
yes
no
Were your caregivers physically abusive?
yes
no
Have you experienced a significant loss? Such as a child, sibling, parent or other close loved one.
yes
no
Do you avoid social gatherings due inability to leave your animals?
yes
no
Do you avoid social gatherings due to embarrassment?
yes
no
Do feel loved?
yes
no
Do you feel that you have a special ability to care for your animals that others cannot provide?
yes
no
Do you take in stray animals regardless of your ability to care for them?
yes
no
Do your pets put a strain on your relationships?
yes
no
Do your neighbors make complaints regarding your pets?
yes
no
Have you ever encountered legal issues regarding your pets?
yes
no
How many of your animals have seen a veterinarian while in your care?
0%
25%
50%
75%
100%
Do you experience health issues related to your pets?
yes
no
Do you have a special relationship with your animals that others don't understand?
yes
no
Do you put your pets needs before your own?
yes
no
Check all below that impact your daily life
unpaid fines
shut off notices
unmanaged debt
respiratory issues
hopelessness
compulsion to obtain animals
isolation
feeling inadequate
Are you forced to use spaces outside of your home to care for your pets?
yes
no
Which of the following spaces in your home are currently inaccessible for any reason?
backyard
kitchen table
bathroom sink
your bed
garage
basement
hallways
living room furniture
dining room
kitchen sink
kitchen counters
1 toilet
more than one toilet
any door entering your home
refrigerator
shower/bathtub
attic
Have you been diagnosed with any of the following
depression
obesssive complusive disorder
post traumatic stress disorder
anxiety
borderline personality disorder
bipolar disorder
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