Feline Preventive Visit
Date of Appointment
Phone # for call or text during pet's visit
Anything you want us to know about your pet since last visit?
Time Spent Outside
Supervised only/ on a leash
As desired - in and out
Does not come in the house at all
Diet- Brand, Amount, Frequency; Treats? People food?
Any change in thirst or urination?
Monthly Prevention Product
Revolution topical (heartworm, ear mites, intestinal worms, fleas) - only available via prescription from a vet
Revolution Plus topical (all of above plus ticks) - only available via prescription from a vet
Feline Heartgard Plus chewable (heartworm and hookworms) - only available via prescription from a vet
Seresto Collar (8 months of killing fleas & ticks only)
Frontline Plus or Gold topical (fleas & ticks only)
Number of doses needed today to continue monthly year-round (best for your pet!)
Best deal is to get 6 or 12 doses of Revolution for a rebate!
Please list any other medications or supplements
Any signs of parasites?
At a preventive care visit for healthy pets, we are able to pass along a great deal from our lab for a discounted preventive panel that includes Complete Blood Count, Metabolic Panel (Chemistry), Blood Infection (Leukemia & FIV), and Intestinal Parasite Screens:
Feline Leukemia & FIV blood test with Intestinal Parasite Screen $70
Basic (Adult) Panel (includes above) $111
Premium (Senior) Panel for $185 (all of above plus urine and thyroid)
Definitely No, not in today's budget
Any medical or behavioral questions or concerns today?
How do you intend to pay for the visit?
Credit card - Mastercard, Visa, Discover
Contactless Payment preferred- we can send you a secure link to your cell phone that you can pay yourself with your card directly
In last 2 weeks, has pet had any potential exposure to person with symptoms of or that has been diagnosed with COVID19?
Should be Empty: