Just Cats Veterinary Services

1015 Evergreen Circle
The Woodlands, TX 77380

(281)367-2287

www.justcatsvets.com

Patient History Form for "Purrside" Appointments

Patient History Form - Purrside

Client Name (required)

Cat's Name (required)

Current Medications (required)

Do you need refills of any medications?

What canned food, brand, flavor, and amount are you offering? (required)

What dry food, brand, flavor, and amount are you offering? (required)

Has your cat vomited or had hairballs in the last 30 days? (required)

Yes
No


What is your cat's lifestyle? (required)

Indoor Only
Indoor/Outdoor Supervised (porch, catio, harness,etc)
Indoor/Outdoor Unsupervised
Outdoor only


Have you noticed any changes in the following areas? (required)
Appetite
Water consumption
Urination
Defecation
Activity level
Reluctance to jump or run
Limping
Itching/ Hair loss
Nasal/Ocular discharge
Sneezing
Coughing
Behavior
None of the above, my cat is purrfect
If yes to any of the above, please elaborate and/or summarize any and all concerns (required)

"Purrside" Policy
We're excited to invite clients back into the building and we know our patients are excited too. In order to proceed with the "purrside" visit, you must agree to the following: Only one (1) person is allowed into the exam room during the time of the exam. Any other person(s) attending the appointment will be asked to remain in the lobby or wait in their car. A face mask is required for the entirety of the visit, and you must agree to follow the staff's instructions regarding social distancing and the process of the visit. You must agree to a few simple questions regarding prior to entering the exam room and agree to reschedule the appointment if you have signs of illness or have been exposed to COVID-19 in the 2 weeks prior to the appointment date. Please understand that you will be asked to exit the exam room and possibly wait in your car if you are unable to follow the instructions for keeping yourself and the JCVS staff safe from contagious diseases.
Please initial below if you have the read the "purrside" policy and agree to follow them accordingly (required)


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1015 Evergreen CircleThe Woodlands, TX 77380

P: (281) 367-2287
F: (281) 367-0700 

vets@justcatsvets.com

Hours of Operation:
Monday-Friday: 7am-6pm
Saturday & Sunday: Closed 

 

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