Annual Wellness Exam Form – CAT – Shannondale Pet Hospital

Owner Info

Name

First Last

Email

Would you like more information on ways to connect with us, access your pet’s medical records, and order medication/products?

What would you like more information on

Our Online Shopping Store (MyVetStore)
Our Mobile App
Pet Insurance
Send information on everything

Would you like 4 free weeks of pet insurance? (No obligations or purchase necessary)

Yes
No

Pet Info

Name

On a normal day, what does your cat eat (Brand/amount)? How often? Example: twice daily, free fed. Please include any treats or people food.

Has your cat had any problems with his or her current food?

Please Explain

Does your cat go outside?

Would you like a reminder through our app to bring a fecal sample for your appointment?

Our doctors are recommending annual parasite screening for all outdoor cats as part of their annual wellness exams. This is to ensure your cat is parasite free as most infestations are not symptomatic and not all parasite preventatives cover the wide range of parasites that our pets can pick up. We have found that when we are testing fecal samples, we sometimes find parasites that need to be addressed. We ask that you bring a sample of your pet’s feces so we can ensure your pet is parasite free.

Is your cat currently on any parasite prevention; example Bravecto, Revolution?

When was the last dose given?

Is your cat over the age of 7?

Do you notice any changes in mobility (this can be very subtle in cats)? Resting in the same location instead of picking many spots throughout the house, reduced jumping, walking more hunched up, less interest in playing, spending more percentage of the day sleeping? Please explain if so.

Do you notice any signs of stress in your cat? ie urinating outside of the litterbox, hiding, fighting with housemates, over grooming, aggression. Please explain if so.

Is there anything specific you would like your pet's medical team to discuss, address concerns about, or provide additional information on?

Would you like more information on wellness screening?

If your pet is over the age of 7 our doctors are recommending screening tests. Running these tests help us understand what’s normal for your pet as well as screen for common conditions. Subtle changes in your pet’s test results can signal the presence of disease even before any outward signs of illness can be seen. It would consist of running a blood sample from your pet that can be taken while they are here for their wellness exam.

Great! Our technician will follow-up with more information and pricing.

Do you have any specific concerns you would like addressed with the doctor?

Please explain

Do you need to pick up any medications, food, or products at your visit?

Please let us know what you need as there may be delays if we need to order it in

Would you like any additional information on a specific topic (behavior issues, medical issues, parasite prevention or product)?

Please let us know what information you would like and our technician will follow-up with you.

If an opportunity becomes available do we have permission to take a picture of your pet and post to our social media platforms? Only your pet’s first name will be used.

Do you have any specific questions and/or concerns you would like addressed?

We are implementing a new program called CoVet. This innovative tool will help us maintain up-to-date and thorough medical records for your beloved pets. What this means is that your visit with us will be recorded through this program and used to update our medical records. The primary aim of using CoVet is to ensure that we provide the best possible care through accurate and comprehensive medical records. Rest assured that all discussions and information recorded during the visit are kept strictly confidential. Do you give permission for us to use this tool during your visit?

Yes
No

Thank you for trusting us with your pet's health

Do you plan on travelling to the United States in the next 30 days?

Yes
No

please click on the link for more information as the CDC has updated their requirements. https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/dogs.html

Annual Wellness Exam - Feline

Owner Info

Pet Info

Thank you for trusting us with your pet's health

please click on the link for more information as the CDC has updated their requirements. https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/dogs.html

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