New Pet Information (Feline)

Please fill out this form, print it out, and bring it with you to your first appointment.

Basic Information

Cat's Name:

Breed of Cat:

Date of Birth:

Age of Cat:

Male Female

neutered/spayed?

How long have you owned this cat?

Years

Months

Days

Where was this cat obtained?

Breeder Private Owner Humane Society/Shelter Pet Store

Vaccination History

	Rabies	FVRCP (Distemper)	FeLV/FIV	Other
Date Given
Date Due

FeLV/FIV Test

Date:

Result:

Fecal Test

Date:

Result:

Flea/Tick

Which flea/tick prevention product do you use?

How often do you use it?

Medical Info

Please list any current medications your cat is taking.

Please list any significant past medical problems.

Please check any of the following that apply to your cat.

Travel Boarded Groomed Indoor Only Outdoor(Supervised Only) Outdoor(Unsupervised)

Diet

What brand do you use?

Amount(cups per day)

Meals per day

Do you leave food out for your pet all day?

Yes No