Pre-Admission Questionnaire | Cat Specialist Services

Feline Pre-Admission Questionnaire

Thank you for booking your appointment with us. The following information is to provide background information for cat’s visit. To complete the form, print and select 'save to PDF' as your print option in your email software. You can fill out the printable version of the form, then save to PDF and email the completed form back to us at vss@vss.net.au. Thank you.

Client Name:: First Name:
Last Name:
Appointment Location::
Patient Name:: Please enter your cat's name
Length of Ownership:: Please enter in years/months
Where did you obtain your cat?:
Number of cats in your household?:: Please enter number of cats
Multiple cats:: If you have more than one cat are they related?
Indoor/outdoor cat?:: Please select preference
Does your cat use a litter tray?:: Please select preference
Number of litter trays:
Your cat's litter preference:: Please select your preference
What is your cat’s diet?:: Please select preference
Please specify food brand:: Please include the brand of the food, and the flavour of the food
Amount of food eaten:: % of total daily food eaten by this cat
Please list any additional diets or supplements given:
What is your cat’s vaccination history?:
Worming and flea control:
Please specify product used:
Has your cat travelled:
Please list countries / Australian states visited:
Is your cat receiving medications currently?:
If Yes, please list here:: Your clinician will review these medications with you at your consultation
I find it easiest to medicate my cat:

Feline Pre-Admission Questionnaire

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