Kitten Booster Vaccine Questionnaire

We hope you have been enjoying your time with your new kitten! Thank you for taking out the time to fill out our questionnaire prior to your appointment. This allows us to see how your kitten has been growing and it allows us to focus in on the things that really matter to you. Please feel free to call 705-522-4555 or email info@lockerbyanimalhospital.com if you have any questions.

CLIENT & PET INFORMATION

Owner/Co-Owner First and Last Name(s) *

Email Address *

Pet's Name *

Pet's Date of Birth

Appointment Date and Time

Who will be bringing your pet to the appointment?

(If this person is not the owner, please indicate their relationship to you and if they are able to make medical and financial decisions on your behalf).

What is the best phone number for the veterinarian to call once the examination is complete to discuss exam findings and diagnostic/treatment recommendations? *

Did you have any concerns about your kitten after his/her last vaccines? If yes, please tell us more.

Is your kitten eating and drinking well? If no, please elaborate:

How is litter training going?

Is your kitten still having fecal/urinary accidents?

Would you like to have your kitten vaccinated against Feline Leukemia Virus at this visit?

The feline leukemia virus (FeLV) is a slowly progressive virus that usually persists in cats’ bodies and interferes with normal immunity. FeLV infection results in an increased risk of infections and cancers. Please ask our team for more information if you are unsure if this is right for your kitten based on his/her lifestyle.

Do you have concerns regarding any behaviours that have arisen since our last visit? If yes, please give details.

Do you have any specific concerns with your pet that you would like addressed at your appointment?

Security Question *

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY *