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What is your cat's name?
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What is the reason for your visit?
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How is your cat doing overall?
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Any changes in mobility?
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Is your cat Indoors, Outdoors or Both?
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How many pets are in your household?
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What food do you feed your cat? (brand, amount, frequency, dry, canned)
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Is your cat eating normal amounts of food?
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Do you think your cat is losing weight?
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Is your cat drinking excessive water?
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Is your cat vomiting? If yes, please describe the frequency and appearance
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Is your cat having diarrhea? If yes, please describe the frequency and appearance
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Any Sneezing or Coughing? If so please describe
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Any changes in behavior?
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Is your cat using the litter box regularly?
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Is your cat urinating and defecating normally? If not please explain
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Any other issues or concerns?
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Please list any medications you are currently giving (name,strength, amount and how often)
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Are you giving your cat any other supplements, remedies, etc?
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Is your cat on flea control? If so which kind and the last time applied
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Has your cat been tested for FELV or FIV if so please indicate if tested negative or positive
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Does your cat have a microchip?
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If we need to send home any medications, would you prefer Liquid or Pills?
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