Email (This should be the main email you would like us to use for your account) (required)
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Cat's Name (required)
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Owner's Name (That account is under in our system) (required)
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Who will be bringing your cat to their appointment? (required)
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What is the best contact number for that person during the scheduled appointment time? (required)
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Is this a cell phone that can accept text message reminders from us?
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Has your cat shown any of the following signs or symptoms? If no, leave blank. If yes, please explain. |
Coughing, gagging, or wheezing?
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Vomiting, Diarrhea or Scooting on rear end?
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Red gums, offensive breath, excessive drooling, or sensitivity while chewing?
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Lameness or difficulty when getting up?
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Lethargy, listlessness or anxiety (hiding or uncontrollable shaking)?
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Unusual body odors, itching, scratching, poor hair coat, hair loss, skin problems or ear odor/head shaking?
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Lumps or bumps?
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Has your cat shown a significant change in any of the following? If no, leave blank. If yes, please explain. |
Change in appetite or increase in drinking?
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Weight gain or loss?
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Change in behavior or litter box use problems?
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Difficulty in Hearing or with Vision?
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ENVIRONMENTAL EXPOSURES AND TESTING |
Infectious Diseases:
Feline Leukemia (FeLV) and Feline Immunodeficiency Virus (FIV)
These diseases are transmitted through bite wounds or other close contact with infected cats and can be fatal. |
We suggest screening +/- vaccination for:
- Cats have had contact, or have been in fights with strays or other outdoor cats |
- Sick cats or cats with chronic infections that don't resolve
- Any new cats (Before exposing to other household cats) |
- ALL new kittens
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Is your cat primarily:
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If your cat goes outside, what is it's exposure to other cats?
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If your cat goes outside, does it hunt and sometimes eat rodents or other animals?
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Routine FeLV/FIV test:
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PREVENTATIVE PRODUCTS: |
Please dispense today:
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Other |
Would you like your cat's nails trimmed today? (There is a fee for this)
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Do you have any other questions or comments about your cat today?
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SENIOR SCREENING / PREVENTATIVE WELLNESS BLOODWORK SCREENING |
When your pet is in for it's Annual Wellness Exam we also offer the opportunity to have us perform some basic lab screening tests at a significant discount to ensure that your pets organs and metabolic functions are all working well.
These tests are even more important if your pet is: |
- Over 7 years old
- Will need general anesthesia for a surgical or dental procedure in the coming months |
- Has any chronic medical conditions
- Receives regular medications for a chronic problem |
Are you interested in Preventative Wellness Screening for your cat today?
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