A Cat's View Veterinary
Hospital

Respiratory Form

 

Respiratory Form

This form is intended to make your appointment more efficient by collecting patient history.  If your cat is having any respiratory problems feel free to submit this form. 

Has your cat been coughing?:
If so, when did it first start?:
Estimate number of times a day your cat is seen coughing?:
Is the coughing sometimes associated with production of a hairball?:
Is your cat sneezing?:
Has there been any vomiting?:
Have you noticed your cat breathing hard at rest?:
Is there now, or has there been any discharge from the nose?:
Please describe discharge if any.:
Are there other cats in the household?:
Are any other cats affected?:
Does your cat seem to have times when it is difficult to breath?:
Please list all medications and frequency for the past month:
Has anyone given your cat Tylenol/Acetaminophen?:
Is your cat's appetite?:
Diet: including treats and supplements?:
Is your cat's energy level?:
Does your cat seem to have lost weight?:
Does anyone in the household smoke?:
Type of cat litter used?:
Is your cat's litter dusty?:
Is your cat:
Are you interested in holistic alternatives?:

 

 

 

 

 

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