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whitehillsah@gmail.com
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Home
About
- Our Story
- Our Team
- Photo Gallery
- FAQs
Services
Resources
MyVetStore
Contact
Appointment

Feline Annual Form

Save time during your feline annual appointment. Complete your required form online from any device at any time before your visit.

feline-annual-form-banner

Feline Annual Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet before your visit.

What is your FIRST and LAST NAME? *

First

Last

What is your CAT'S NAME? *

What is your phone number?

Has your cat ever had an adverse reaction to vaccinations?

Yes
No

Please Specify

Does your cat have a cough? If coughing, When did it start? When does it occur? Is it getting worse or resolving?

Is your cat sneezing? If sneezing, when did it start? When does it occur? Is it getting worse or resolving? Is there a discharge? If so, what color

Is your cat vomiting? If vomiting, when did it start? When does it occur (how soon aftereating)? Is it getting worse or resolving? Is there blood in the vomitus? What is vomited? 'Any history of dietary indiscretion?

Does your cat have diarrhea? (if no, answer no to following questions.)

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When did it start?

What is the fecal consistency?

Is it getting worse or resolving?

Any history of dietary indiscretion?

Is there blood or mucous in the feces?

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Does your cat have tremors or seizures?

Yes
No

Please Specify

Any new or changing lumps/bumps/skin lesions?

Yes
No

Please Specify

Any changes in urination?

Yes
No

Please Specify

Has your cat been eliminating outside of the litterbox?

Yes
No

Please Specify

Is your cat scratching, have a rash or hair loss?

Yes
No

Please Specify

Any change in thirst?

Yes
No

Please Specify

Has the elimination (BM and urination) habits changed since last visit?

Yes
No

Please Specify

What meds are currently being given to your pet, and when was the last dose given?

How much water does your cat consume per day?

Food

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What type of food do you feed?

Does your cat receive any table food?

How much and how often?

Can they have treats while they are here in the clinic?

Does your cat receive any supplements and when was last dose given?

Does your cat receive any medications, and when was last dose given?

Does your cat receive any over the counter flea products (spot-on, shampoos, foams, sprays) & when was last dose given?

Yes
No

Please Specify

Any changes in...

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Vision?

Hearing?

Temperament?

Do you consider these behaviours a problem?

Yes
No

Please Specify

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

Yes
No

Please Specify

Any changes in mobility (gait changes/stiffness/sore to touch)?

Yes
No

Please Specify

Have you noticed any changes in the way that your pet greets or interacts with other petsor people? Has there ever been a concern with biting or nipping at other pets or people?

Yes
No

Please Specify

Any new fears or phobias since last visit?

Yes
No

Please Specify

Does your pet currently have any behaviour problems that you are concerned about?

Yes
No

Please Specify

Lifestyle

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Is your pet a strictly indoor cat?

History of travel outside London?

Plans to board?

If no, are we outdoors supervised or unsupervised?

Plans to travel outside London?

We recommend that core vaccinations (Rabies and upper respiratory virus vaccines) are kept up to date to ensure the protection of your pet against serious diseases. This includes indoor cats. WOULD YOU LIKE TO UPDATE CORE VACCINES TODAY (IF DUE)?

Yes
No
I would like more information

Feline Leukemia Virus is a serious disease that is passed through contact between cats. Vaccination is recommended for any cats that will be in close contact with stray cats or cats with an unknown vaccination status (ie outside unsupervised). WOULD YOU LIKE THEFELINE LEUKEMIA VACCINE TODAY?

Yes
No
I would like more information

Any pets at home that don't come to Whitehills?

Yes
No

Please Specify

Has your pet been in any fights in the last year?

History of boarding?

Any other observations or concerns?

Are there any specific areas on your pets body that they are very nervous of having touched/ don't like having handled?

If your cat is 10 years of age or older, we recommend annual blood pressure checks due to an increase in hypertensive cases, and the benefit of early intervention. The cost is $56 +HST. Do you consent to this?

Yes
No
I would like more information
Not applicable, my pet is under the age of 10

Questions for COVID19 screening:

Have you, or someone you live with, been sick with symptoms associated with Covid19 in the last 5 days?

Phone

Make an Appointment

You can schedule an appointment by clicking the button below.

QUESTIONS?

We look forward to hearing from you!

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Address:

2111 Aldersbrook Rd.
London, ON N6G 3X1

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Contact Information

Phone: (519) 473-1182
E-mail: whitehillsah@gmail.com

Name *

First

Last

Email *

Phone

How can we help you? *

Name

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Hours

Mon & Wed: 8:00am – 7:30pm
Tues, Thurs & Fri: 8:00am – 6:00pm
Sat: 8:00am – 12:00pm
Sun: Closed

Our phone lines are off for lunch daily from 12:30 pm – 1:30 pm.
The phones are turned off 1 hour prior to close.
On Saturdays, our phones are turned off at 10:00am.

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