New Feline Form

SHERIDAN ANIMAL HOSPITAL
2288 Sheridan Drive • Buffalo, New York 14223
Telephone (716) 833-2255 • Fax (716) 833-8525

Date*

Pet's Name*

Owner's Name*

What breed is your cat?

Sex
MaleFemale

Color

Birth-date or approx. age:

Where did you obtain your cat?

How long have you had your cat?

Is your cat Microchipped?
YesNo

If yes, what is the microchip number?

What kind of cat food do you feed?
WetDryBoth

How much & how often? (ex. 1/4 cup, 2x a day)

What kind of treats do you feed?

How many & how often?

Is your pet’s housing primarily:
Indooror Outdoor?

Do you have any other pets at home?

What activities does your cat (or do you plan for your cat) to participate in? (Check all that apply).
Walks in the neighborhoodBoarding kennelCat showsBreedingGroomingShopping at pet storesOther outside of the home adventures (School, nursing home, other)

Has your cat ever had any serious illness in the past? Please explain.

Is your cat currently on any medication or supplements?
YesNo

If yes, please list the drug, strength and dosing directions:

Is your cat up to date with vaccinations?
YesNo

List vaccines and when due if known.

Are there any specific health or behavioral questions you would like to discuss at your visit?