Feline Pet Risk Assessment Form
Help us learn more about your cat by checking all of the following that apply:
My cat lives totally indoors
My cat has contact with other cats that have access outdoors
I feed the stray cats in my neighborhood
My cat is mostly outdoors
My cat goes inside and outside
My cat loves to roam the neighborhood
My cat loves to hunt
My cat fights other cats
My cat fights other dogs
My cat fights another type of animal
My cat goes to the groomer
My cat has tested positive for feline leukemia in the past
My cat has tested positive for feline AIDS in the past
My cat is used in a breeding program and/or attends cat shows
My cat boards when we go away on vacation
My cat travels with me when I go on vacation
My cat has been diagnosed with
chronic disease(s).
My cat's current diet:
ex. Friskies, Pro-plan
Current flea/tick preventative
ex. flea collar, Frontline, Revolution
NEW Adult (Age 1-6 years) Feline Wellness Basic Panel ($205.00) includes CBC, Chemistry, Urinalysis, Retroviral (FeLV/FIV), SDMA
NEW Senior (Age 7+ years) Feline Wellness Comprehensive Panel ($228.00) includes CBC, Chemistry, Thyroid evaluation, Urinalysis, Retroviral (FeLV/FIV), SDMA
I would like to have my cat to have a fecal to check for intestinal parasites (recommended for outdoor cats).
Doctor is authorized to proceed with services based on his/her recommendation
For my pet, I decline any additional tests. Please give vaccines only.
For my senior pet, I would like vaccines and the following tests only:
Urinalysis ($72.00)
Blood Pressure ($43.00)
Pet Name
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Client Name
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