Feline Annual Wellness - VMS Veterinary Medicine and Surgery

It's Time For Your Kitten or Cat's Yearly Exam

Feline Annual Wellness Form

First Name

Last Name

Phone

Pet Name

Pet Breed

Date of Birth

Sex

Spayed / Neutered

What type of food do you feed your cat and how much?

How many hours a day does your cat spend outside?

Does your cat have access to other cats that go outside?

Does your cat go to a groomer or boarding facility frequently?

Do you want FELV/FIV testing today at an additional charge of $60?

Do you use any type of flea and tick control (do you need a refill today)?

Do you use any type of heartworm prevention (do you need a refill today)?

Any coughing, sneezing, vomiting, diarrhea?

Any problems that you know of at this time?

Have you noticed any changes in your pet's behavior since the last visit?

Is your pet on any medications? If yes, what kind, how often, and do you need a refill today?

How often do you use hairball treatment for your pet?

Has your pet ever had a vaccine reaction?

Do you have an insurance policy for your pet?

Is your cat microchipped?

Thank you for completing our Feline Annual Wellness Form. Please press the submit button to send this form to our main office.