Patient History - Feline Wellness Visit
Cell Phone (we will need to reach you to discuss the exam)
What is the make, model and color of the vehicle you are in today?
Reason for Visit
Is your cat eating, drinking, urinating and defecating normally? If not, please explain:
Do we have permission to update vaccinations that are due or past due? These may include:
Purevax Rabies 1yr
Purevax Rabies 3yr
Feline Rhino/Calici/Panleuk Viruses
Do we have permission to update wellness testing that may be due or past due? Please select the following:
Intestinal Parasite Screening
Comprehensive Wellness Screening that includes fecal, urine, full-body chemistries
Are there any issues you would like to address with the doctor today?
Please list your pet's current medications, including dosage:
Please tell us what brand of food your pet eats, as well as the amount and how often he/she is fed:
Is your cat current on flea/tick and heartworm medication?
Do you need any medication refills today? Please select one of the below or list in "Other".
6 months Flea/Tick
12 months Flea/Tick
Does your cat go outside?
Sometimes goes in the yard
Should be Empty: