New Client Form

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First Name

Last Name

Spouse First Name

Spouse Last Name

Street Address

City

State

Zip Code

Home Phone

Work Phone

Cell Phone

Emergency Contact & Phone

Previous Veterinarian/Clinic

Client NameWho referred you to us?

OtherPlease let us know who referred you

Patient Information

NamePlease only enter one name

Birth Dateor their approximate age

Breed

Color

Indoor or Outdoor Cat?

IndoorOutdoorSupervised Outdoors

Temperment

CalmNervousDifficult

Does your cat get sedated for appointments and/or grooming?

Is your cat declawed?

YesNo

Which claws are missing?

FrontBack

What do you feed your cat?

Dry foodCanned food

Brand of dry food?

Brand of canned food?

Chronic Ailment(s)

0 /

Continuous Medication(s)

0 /

Behavior Assessment

Does your cat urinate or defecate outside the box?

UrinateDefecateBoth

Have the been any changes in your cat's behavior or disposition?

YesNo

Does your cat show signs of aggression to people, including hissing, biting or scratching?

YesNo

Have you noticed any changes in your cat's health?

	Never	Rarely	Sometimes	Often
More frequent urination?
Signs of increased stiffness, limping, difficulty climging stairs?
Noticeable weight gain or loss?
Bad breath or red and swollen gums?
An increase in appetite?
A decrease in appetite?
Vomiting?
Diarrhea or stool with mucus or blood?
Constipation or difficulty defecating?
An obvious increase in thirst and excessive water drinking?

Do you have any other concerns or worries about your pet?Anything that wasn't included above?

0 /

Please be sure to bring all cats in a cat carrier (hard plastic preferred)

I have read and agree to bring my cat in a cat carrier

Acceptable methods of payment

All fees must be paid in full at the time of services. We accept Visa, MasterCard, American Express and Discover. We do not accept checks from new clients. We do, however, accept checks once you are established. We also accept cash.

Cancellation/No show policies

Please familiarize yourself with our cancellation and no show policy available on our website and plan accordingly. https://pawswhiskersandclaws.com/policies/

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Monday	9 am - 5:30 pm
Tuesday	9 am - 5:30 pm
Wednesday	Closed
Thursday	9 am - 5:30 pm
Friday	9 am - 5:30 pm
Alternating Saturdays	9 am - 1 pm
Sunday	Closed

(770) 579-6001

New Client Form

How to Find Us

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