Medical Appointment Visit

Client Information
Name*
First Last
Cat's Name*
First
Phone*
Main Reason for Visit
Main reason for today's visit*
Has your cat shown similar symptoms in the past?*
- No
- Yes
If yes, please indicate when:
Are other pets at home showing similar symptoms?*
- Yes
- No
- No other pets at home
If yes, please describe:
Has your cat been seen for this issue at another veterinary clinic?*
- Yes
- No
If yes, please indicate the clinic(s)
Additional Symptoms
Have you observed the following symptoms in your cat at home?*
- Vomiting
- Diarrhea
- Constipating/Defecating less than usual
- Coughing/Sneezing
- Drinking less than usual
- Drinking more than usual
- Eating more than usual
- Eating less than usual
- Changes in weight
- Peeing more than usual
- Peeing less than usual
- Changes in Behaviour (peeing outside of box, hiding, aggression, altered sleep etc)
- Changes in Mobility (Hesitation to jump, reduce activity, limping, etc.)
- Itching, Scratching, Losing fur
Please select all that apply
Please provide details for the symptoms you selected in the box below, including when they started and how frequently they occur.*
General Patient Information
Please indicat what types of food your cat normally receives*
- Dry kibble
- Wet/canned
- Raw food
- Home cooked food
- Treats
- Other
Please select all that apply
Please list the brands and quantity/frequency your cat is fed of each food type. Please include any changes from your cat's normal feeding routine.
Does your cat currently take any medications or supplements?*
- Yes
- No
Please list any prescriptions or supplements your cat currently takes in the box below, along with the dosage and frequency of administration.
Are there any other additional details you would like to provide before your cat's visit with us?

Have a Question? Need to book an appointment?

Contact Us

15 Surrey St W
Guelph, ON N1H 3R3

info@guelphcat.com

519-821-2287

Hours of Operation

Monday-Friday:
8am – 6pm

Saturday:
9am – 2pm

Sunday:
Closed

Medical Appointment Visit

Medical Appointment Visit

Client Information

Main Reason for Visit

Additional Symptoms

General Patient Information

Have a Question? Need to book an appointment?

Contact Us

Hours of Operation