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Mass Ave
Fountain Square
Irvington
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Search for:
Feline Health Questionnaire
At which location does your pet have an appointment?
*
Location
Irvington
Fall Creek Place
Fountain Square
Mass Ave
Client Name
*
First
Last
Pet Name
*
Is your cat eating normally?
*
Yes
No
If your cat has not been eating normally, what changes have you noticed?
Has your cat’s weight or appetite changed in the last year?
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Yes
No
Have you noticed any new lumps or bumps on your cat?
*
Yes
No
If you have noticed any new lumps or bumps, where?
Does your cat drink or urinate more than usual?
*
(Are you cleaning out the litter box more than usual recently?)
Yes
No
Does your cat urinate or defecate outside of the litter box?
*
Yes
No
If your cat is urinating/defecating outside of the litter box, how often?
Does your cat vomit or have diarrhea more than one time per week?
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Yes
No
Does your cat’s breath have a bad odor?
*
Yes
No
Do you do any form of at-home dental care?
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Yes
No
If you do provide at-home dental care, what do you use?
Does your cat throw up hairballs?
*
Yes
No
Do you think your cat has any symptoms of arthritis?
*
Yes
No
Does your cat cough or sneeze regularly?
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Yes
No
Has your cat has had fleas or ticks in the past?
*
Yes
No
Do you give your cat heartworm prevention?
*
Yes
No
What brand of heartworm prevention do you use?
Do you give heartworm products year-round?
Yes
No
Do you give your cat monthly flea/tick prevention?
*
Yes
No
What brand of flea/tick prevention do you use?
Do you need to purchase any of these products today? (Check all that apply.)
*
Flea/Tick - Yes!
Heartworm - Yes!
I do not need any products.
What kind (brand and type) of food do you feed your cat?
*
Is your cat taking any medications other than heartworm/flea/tick prevention?
*
Yes
No
If your cat is taking other medications, please explain.
Is your cat getting any supplements?
*
Examples: CBD, fatty acids, joint supplements, vitamins, etc.
Yes
No
If your cat is getting supplements, please list.
Does your cat have any history of allergies?
*
Examples: vaccines, food, medications, seasonal, etc.
Yes
No
If your cat has a history of allergies, please explain.
Is your cat spayed or neutered?
*
Yes
No
If your cat is not spayed or neutered, please explain why.
Is your cat microchipped?
*
Yes
No
Do you have any other concerns about your cat?
Email
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