New Client Form 1 Step 1 First Nameno-icon Last Nameno-icon Spouse First Nameno-icon Spouse Last Nameno-icon Street Addressno-icon Cityno-icon Stateno-icon Zip Codeno-icon Home Phoneno-icon Work Phoneno-icon Cell Phoneno-icon Emailemail Emergency Contact & Phoneno-icon Previous Veterinarian/Clinicno-icon How did you hear about us?Good MewsPWC Web SiteYahooYellow PagesFlyerGoogleDrive/WalkbyClientOther Client NameWho referred you to us?no-icon OtherPlease let us know who referred youno-icon Patient Information NamePlease only enter one nameno-icon Birth Dateor their approximate ageno-icon SexMaleMale NeuteredFemaleFemale SpayedNot Sure Breedno-icon Colorno-icon Indoor or Outdoor Cat?IndoorOutdoorSupervised Outdoors TempermentCalmNervousDifficult Does your cat get sedated for appointments and/or grooming?no-icon Is your cat declawed?YesNo Which claws are missing?FrontBack What do you feed your cat?Dry foodCanned food Brand of dry food?no-icon Brand of canned food?no-icon 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? NeverRarelySometimesOftenMore 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 paymentAll 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 policiesPlease familiarize yourself with our cancellation and no show policy available on our website and plan accordingly. https://pawswhiskersandclaws.com/policies/ Submit keyboard_arrow_leftPrevious Nextkeyboard_arrow_right FormCraft - WordPress form builder