Skip to content

Home
Services
Holistic Care
About
Resources
Contact
Emergency
Employment

Menu

Home
Services
Holistic Care
About
Resources
Contact
Emergency
Employment

503-655-1722 22320 Salamo RoadWest Linn,
OR 97068

veterinarian-west-linn-or-2

22320 Salamo Rd,
West Linn, OR 97068

Call / Text: 503-655-1722

veterinary-appointment

Home » Feline Annual Exam

Feline Annual Exam History

"*" indicates required fields

Pet Name:*

Client Name*

First Last

Name & Phone Number for Decisions*

Email*

Do you have time constraints?*

Does your pet have insurance?*

Yes

No

If "Yes" above please let us know which Insurance Company

For today's visit the following symptoms are present:

No symptoms present

Coughing

Sneezing

Vomiting

Diarrhea

Lethargy

Lameness

Itching

Lumps/Bumps

Other Symptoms/Concerns (list):

Other Symptoms/Concerns (list):*

Monthly heartworm / deworming / flea preventive:*

None

Bravecto

Revolution

Cheristin

Vectra

Frontline

Advantage

Current medications/supplements and dose given:*

Diet:*

Appetite:*

Normal

Decreased

Increased

Any change in food/treats?*

YES

NO

Water Intake*

Normal

Decreased

Increased

Activity Level*

Normal

Abnormal

Food Allergies?*

Other Allergies?*

Any seizures?*

Percentage of time spent indoors:*

HISTORY

How is your pet doing at home?*

Have you noticed any changes to their normal behavior?*

YES

NO

What concerns that you would like to address today?*

Do you need any medication refills?*

YES

NO

Other

Vaccine Lifestyle Information and Consent

Is there exposure to other cats (outdoors/boarding/grooming)?*

YES

NO

Is there exposure to wildlife (bats/raccoons/skunks/etc.)?*

YES

NO

Vaccines Accepted/Declined for Upcoming Year

FVRCP:*

Accepted

Declined

Rabies Vaccine Accepted/Declined for Upcoming Year:*

Accepted (1 year)

Accepted (3 year)

Declined

FeLV (leukemia vaccine for cats with exposure to other cats / outdoors):*

Accepted

Declined

Entering Your Full Name Here Will Serve As Your Digital Signature:*

Date*

MM slash DD slash YYYY

CAPTCHA

Email

This field is for validation purposes and should be left unchanged.

Search

Facebook Instagram Twitter Youtube

telemedicine-btn

Contact Us

Contact
Appointments
Directions
Emergency
Online Survey

Contact
Appointments
Directions
Emergency
Online Survey

QUICK LINKS

Web Accessibility Policy
Terms of Use
Privacy Policy
Hospital Blog
Hospital Forms

Cascade Summit Animal Hospital © 2020
22320 Salamo Road, West Linn OR 97068

Call or Text 503-655-1722

HOSPITAL AFFILIATIONS

Oregon Veterinary Medical Association

Veterinary Website Design by Cheshire Partners LLC

OFFICE HOURS

Monday – Friday:
8:00am – 6:00pm

Saturday – Sunday:
Closed