Highlands Veterinary Hospital - New Feline Patient

1

All new clients will be required to pre-pay for their exam fee over the phone to schedule an appointment. Please call after filling these forms out for us to get you scheduled.

2

Owner Information* This field is required.

Name

Phone

Email

3

Pet Information* This field is required.

Name of Pet

Estimated Age or Birthdate

Breed

Color

4

How long have you owned this pet?

5

Hair Coat Length (circle one)* This field is required.

Short

Medium

Long

7

Does your cat have a microchip?

YESNO

8

Does your cat live (circle one)?

Inside Only

Outside Only

Inside & Outside

9

Does your pet have any known or suspected food or drug allergies?* This field is required.

Yes

No

10

If yes, please describe

11

Previous Medical Conditions

12

Previous Surgeries or Serious Illnesses (date and description)

13

Please list any long-term medication(s) and/or supplements pet is taking, please include dosage if known?

14

Additional concerns or information

15

Would you like us to request records for this pet from another veterinary facility?

Yes

No

16

If yes, name of facility

17

My cat is aggressive toward

Yes

No

Other Animals

Other people

Other Animals

Other people

Yes

No

Yes

No