Javascript must be enabled for the correct page display
Happy Holidays! 🎄 We will be closed on December 24th - 25th and January 1st. We will close at 4 pm on 12/31 New Year's Eve. 🎊
If your pet is experiencing an emergency, please contact the
Charleston Veterinary Referral Center
at 843-614-8387
Hours & Contact
Monday - Friday: 8:00am - 6:00pm
(843) 483-5838
[email protected]
facebook
twitter
instagram
Menu
Services
Cat Services
Cat Anesthesia
Cat Behavior
Cat Dental Care
Cat Diabetes Mellitus
Cat Medication Administration
Cat Preventive Care
Cat Vaccinations
Kitten Care
Senior Pet Care for Cats
Dog Services
Dog Anesthesia Services
Dog Behavior
Dog Dental Care
Dog Preventive Care
Dog Medication Administration
Dog Vaccinations
Puppy Care
Puppy Socialization
Senior Pet Care for Dogs
Diagnostic Services
Cancer Screening
Digital Radiography
Electrocardiography (ECG)
In-House Diagnostic Laboratory
Ultrasonography
Behavioral Medicine
Dentistry
Surgery
Laser Therapy
About Us
Meet the Team
Veterinarians
Support Staff
The Brains Behind It All
Careers
Veterinary Nurse
Veterinary Nurse Assistant
Client Service Representative
Associate DVM
Mentorship / Preceptorship
Fear Free Certified
Photo Gallery
In The News
Protocols, protocols, protocols!
Team Training
PIZZA!
Introducing VetPawer AVA
Community Service
Why AAHA?
Forms
Resources
Payment Options
Blog
FAQs
A Pet Owner's Guide to Mt. Pleasant, South Carolina
Contact Us
Search
Button Bar
Feline Wellness Screening Form
Cat's name:
Your name:
Your email address:
How did your cat become a part of your family? (rescue, stray, breeder, friend/family, etc.)
- None -
Rescue
Stray
Breeder
Friend/Family
Other
If other, please explain:
Is your cat experiencing sneezing or coughing?
- None -
yes
No
If yes, please explain:
Is your cat vomiting or having diarrhea?
- None -
yes
No
If yes, please explain:
Have you noted if your cat’s breath smells bad or has a lot of tartar buildup?
- None -
yes
No
If yes, please explain:
Have you noted any changes to the amount of water your cat drinks or urine production?
- None -
yes
No
If yes, please explain:
Is your cat on a monthly heartworm preventative?
- None -
yes
No
If yes, what brand?
When was the last does given?
Is your cat on a monthly flea and tick preventative?
- None -
yes
No
If yes, what brand are you using?
When was the last dose given?
What brand of food do you feed your cat?
How much do you offer at each feeding?
How often do you offer food?
- None -
Once daily
Twice daily
Free feed throughout the day
Have you noted any changes in your cat's activity?
- None -
yes
No
If yes, please explain:
Have you noted any new lumps, bumps or sores that you are concerned about?
- None -
yes
No
If yes, please explain:
Do you plan on having your pet boarded or groomed by a professional groomer?
- None -
yes
No
Do you have any questions or concerns to discuss with your doctor?
- None -
yes
No
If yes, please explain:
Do you need a refill of your cat's medication(s) while you are here?
- None -
yes
No
Medication 1:
Medication 2:
Medication 3:
Do you have any concerns, complaints, or problems with urination in the house now?
- None -
yes
No
Do you have any concerns, complaints, or problems with defecation in the house now?
- None -
yes
No
Does your cat destroy any objects or anything else by chewing, sucking, or eliminating on them (eg, furniture, rugs, clothes, etc) now?
- None -
yes
No
Does your cat seem overly stressed when going into a pet carrier, riding in the car, during the vet visit, or while boarding? (panting, yowling, urinating/defecating in the carrier).
- None -
Yes
No
If yes, please explain:
Does your pet show any reluctance to get in the carrier or car?
- None -
Yes
No
How would you describe your pet's behavior during travel? (select all that apply):
Eager & excited
Subdued
More quiet than usual
More vocal than usual
Does your pet do any of the following during travel?(select all that apply):
Pant
Tremble
Pace
Hide
Drool
Vomit
Poop
Pee
Are there any situations that your pet has tried to avoid or seemed to dislike of in the past? (select all that apply):
Entering the vet hospital
Unfamiliar people or animals
Being weighed
Going into the exam room
Being put up on the exam table
Having a rectal temperature taken
Ear exam
Cleaning
Nail trim
Other…
Enter other…
Has your pet ever been given any supplements or prescribed any medications to help manage his/her fear or anxiety associated with the visit? If so, what was it and what sort of results did you experience?
Does your cat live inside/outside/both?
- None -
Inside
Outside
Both
Does your cat mouth, bite, suck, or nip anything or anyone?
- None -
yes
No
Does your cat make any sounds about which you are concerned
- None -
yes
No
Does your cat avoid, seem uncomfortable with or otherwise avoid loud noises (storms, fireworks)?
- None -
yes
No
Does your cat show any signs of hissing, growling, or biting?
- None -
yes
No
Have you ever been concerned that your cat is “aggressive” to people?
- None -
yes
No
Have you ever been concerned that your cat is “aggressive” to cats?
- None -
yes
No
Have you ever been concerned that your cat is “aggressive” to animals other than cats?
- None -
yes
No
Has your cat ever bitten or clawed anyone, regardless of the circumstances?
- None -
Yes
No
Has anyone ever told you that they were afraid of your cat?
- None -
Yes
No
Has your cat had any changes in sleep habits?
- None -
Yes
No
Has your cat had any changes in eating habits?
- None -
Yes
No
Has your cat’s ability to move around, climb stairs, jump up on the couch, windowsill, or bed changed?
- None -
Yes
No
Is your cat behaving in any way that worries you or about which you would like more information?
- None -
Yes
No
If yes, please explain:
