Cat Exam Form - Olde Towne Pet Resort

Brand of food fed at home:
Has your cat had any vomiting or
diarrhea in the last 2 weeks?
Yes No
Quantity at check in:
Cat Examination Form:
Cat’s Name: _______________________________________ Suite Number: _____ Weight: _____
Eyes
Ears
Coat
Fleas & Ticks
Nose / Teeth / Gums
Feet / Pads / Nails
Hips & Joints
Abrasions
Lumps
Major Medical Problems
Allergies
Currently on Medications
Clear: Cloudy: Crusty: Red: Drainage:
Normal:
Needs Cleaning:
Possible Infection:
Normal: Thin: Dry: Oily:
Needs a bath:
Matted: Hot Spots:
Is your pet on flea & tick preventative? NO:
YES: Name: ___________________________
Nose: Drainage or crusty?
Teeth: Need dental?
Gums: Sore/Bleeding/Pink?
Feet: Red between the toes?
Pads: Dry or cracked?
Nails: Need to be trimmed?
Is your cat declawed? YES: NO:
Front: Back: Both:
Note:
Note:
Note:
Note:
Seasonal Skin Food
List:
None Seen:
Normal:
Abnormal:
Normal:
Abnormal:
YES:
NO:
YES:
NO:
YES:
NO:
YES:
NO:
YES:
NO:
If your cat is finicky in his/her eating habits, may we supplement his/her diet with something else? Tuna
___ Canned Food ____ Baby Food ____ Chicken ____ Any of these ___ Other_________
If your cat develops digestive upsets while boarding, may we fast your pet one meal? Yes No
May we feed your cat house food if their food runs out? Yes No
Some cats exhibit symptoms of stress while boarding. If your cat should become stressed we have an
Revised 4/1/11

All-natural flower remedy called Rescue Remedy. Would this be okay to give to your cat? Yes
No
Owner’s Signature: __________________________________________ Date: ________________
Examiner’s Signature: ________________________________________ Date: ________________
Additional Notes: __________________________________________________
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Revised 4/1/11