Cat Wellness Annual History Form


 

How This Works:

 

Save time by filling out this history form before your appointment!

 

Please provide as much information as you can to help our veterinary staff give your pet the best care!

 

Please contact us with any questions:

Phone: 563-285-7891

frontdesk@risiusfamilyvet.com

Wellness (Annual Visit) - Cat

  • Pet Information

    Please fill out one form per pet, or indicate where differences lie between pets!
  • General Medical Questions

  • Please include concerns about appetite, vomiting, stool, urination, behavior, skin, etc.
  • How long has the concern been going on? What have you tried at home? Is it better/worse/same?
  • Please provide any comments in the "Other" line
  • Dietary Information

  • Please include brand and type of food, canned or dry, quantity fed, and frequency fed. IE: Purina Indoor Dry 1/4 cup twice daily, or Fancy Feast Classics, 1 can twice daily.
  • Include commercial, home-prepared treat, or table/human food here.
  • Household Management

  • Is there one box per floor? All in the basement? All in closets or bathrooms? Tell us more about box placement, please.
  • How often are the boxes scooped (if clumping litter)? How often are the boxes thoroughly cleaned?
  • Dental Questions

  • Include dental treats & frequency done/given.
  • Infectious Disease Risk

  • Misc Info

  • If yes, what kind? When was the last dose?
  • Pet Information

    Please fill out one form per pet, or indicate where differences lie between pets!
  • Please include concerns about appetite, vomiting, stool, urination, skin, ears, or behavior.
  • How long has the concern been going on? What have you tried at home? Is it better/worse/same?
  • Please provide any comments in the "Other" line
  • Diet

  • Please include brand and type of food (IE Science Diet Light Chicken/Rice), canned or dry, quantity fed, and frequency.
  • Please give details about treats in the "Other" field (what / how much / how often)
  • We're not out to shame you, it's important for history purposes. Please include details (what/qty/frequency) about people treats in the "Other" field.
  • Dental History

  • Please include details about brushing (if you do, how often), dental treats used, oral rinses used, etc.
  • Infectious Disease Risk

  • If yes, please indicate how in the "Other" section
  • General Medical Information