Wellness Check In: Cats over 6 months (1)

Wellness Check-In Form: Cats over 6 months old

Please be prepared for this form to take about 10 minutes to fill out. If you are a new client, please have your pets medical records handy as there will be a section to upload them at the end of this form.
Client Name*

First NameLast Name
Pet Information
Name *
Age
Sex
Breed

What food are you feeding your pet currently and how often? *
Is your pet's appetite normal? *
How has your pets appetite changed? Is this a new problem or ongoing? Is there anything else you want us to know about this problem?
Has your pet had any vomiting or diarrhea recently? *
How often is your pet experiencing vomiting or diarrhea? Is this a new problem or ongoing? Is there anything else you want us to know about this problem?
Has your pet had any coughing or sneezing recently? *
How often is your pet experiencing coughing or sneezing? Is this a new problem or ongoing? Is there anything else you want us to know about this problem?
Is your pet drinking and urinating normal? *
What has changed with their drinking and urination habits? Is this a new problem or ongoing? Is there anything else you want us to know about this problem?
Is your pet on any current medications besides heartworm, flea and tick prevention? *
What medications are they currently on? Please list the dosage they are getting and how often you are giving it.
Do you need any refills for any of these medications? If yes, please list which ones.
Do you have any other questions or concerns that you want to discuss during your pet's visit? *

Vaccinations we recommend for all cats:
- Rabies: 1 or 3 Year
  - If your pet is up to date or within 30 days of the due date for their current Rabies vaccine, the one given will be a 3 year.
- FVRCP (Feline Viral Rhinotracheitis, Calicivirus, and Panleukopenia): 1 or 3 Year
  - If your pet is up to date or within 30 days of the due date for their current FVRCP vaccine, the one given will be a 3 year.
- Feline Leukemia (FeLV): 1 Year or 2 Year
  - If your pet is up to date or within 30 days of the due date for their current FeLV vaccine, the one given will be a 2 year.
  - If your pet spends any time outside we recommend FeLV vaccine.
What vaccines does your pet need? If you don't know, leave blank and we will look at your pet's records to help figure it out.

RabiesFVRCPFeline Leukemia

Is your pet on heartworm or flea/tick prevention? (ex: Revolution, Bravecto, Selarid, Advantage)
What type of prevention are you giving currently?

Wellness Plans

We offer Wellness Plans at Paw Haven. These are tiered subscription-based plans that include all of your pet's wellness needs.

Wellness Plan Inclusions:
- Annual physical examination by a veterinarian
- Sick Appointment Co-Pay $30
- Recheck Appointments Co-Pay $20
- Unlimited technician appointments for preventative care services deemed necessary by our veterinarians
- Preventative vaccinations
- Annual diagnostics based on tier selection (Intestinal parasite screen, FeLV/FIV testing, +/- organ function testing based on plan selection)
- Any other preventative care services recommended by our veterinarians
- 10% off all flea/tick preventatives
Dental Cleaning and/or Spay/Neuter Add-Ons
- These are add-on options for wellness plans that include:
  - Dental: routine dental cleaning with x-rays annually, includes pre-op bloodwork
  - Spay/Neuter: entire spay/neuter procedure including pre-op bloodwork, medications to go home and medical pet shirt or cone.
To Learn Specifics for the Wellness Plans please visit our website for pricing and detailed inclusions: Wellness Plans at Paw Haven
Do you want to sign up for a wellness plan for your pet? If you would like to sign up for a Wellness Plan we will send you the contract to sign before your appointment. Payment will not be taken until the appointment.

Please upload any records you have for your pet including vaccine reminders.

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Wellness Check-In Form: Cats over 6 months old