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

Feline Problem Form

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

feline-problem-banner

Feline Problem Form

Please fill out this form completely and accurately so we can learn as much as possible about your concerns.

What is your FIRST and LAST NAME? *

First

Last

What is your CAT'S NAME? *

What is your phone number?

What is your concern?

When was it first noted?

Date / Time

Date

Time

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Are any other contact animals affected?

Yes
No

Please Specify

Has anything been given at home to treat the problem?

Yes
No

Please Specify

What meds are currently being given and when was last dose given?

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 change in urination?

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 your cat been eliminating outside of the litterbox?

Yes
No

Please Specify

How much water does your cat consume per day?

Food

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Does your cat have a good appetite?

How much and how often?

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

What type of food do you feed?

Does your cat receive any table food?

When will your cat have last eaten before its appointment? *

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

Any changes in...

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Vision?

Hearing?

Temperament?

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

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?

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?

COVID19 screening:

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

Name

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: office@whitehillsanimalhospital.com

Name *

First

Last

Email *

Phone

How can we help you? *

Website

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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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