cat

Ace of Spays Cat Sign-In Form Copyright 2012

PLEASE NOTE: We will not recieve your form information until you click the submit button below and you see a Thank You Screen.

*Date of Your Appointment (required)

Referred by:

Owner Information

Mr/Ms/Dr

*First Name (required)

*Last Name (required)

*Street Address (required)

*City (required)

State (required)

This field is required. Use the drop down arrow to chose your state.

*Zip Code (required)

*Email Address (required)

*Re-Enter Email address (required)

*Phone Number (required)***

This is a required field

Alternate Phone Number

***IMPORTANT: Please provide phone numbers where you can be reached ALL DAY while your pet is with us.

Cat's Information

*Name (required)

*Estimated Age (required)

Birthday

*Species & Sex (required)

*How many testicles are visible? (required)

NOTE: We will call you in the morning after exams in the rare case that both testicles are not where they belong. If we cannot reach you, we will NOT do any surgery.

Sometimes the testicles are difficult to see. If a veterinarian has told you your pet has retained testicles, please cancel your appointment with us. We do not provide surgery for retained testicles. If a veterinarian has not advised you about your cat, bring him at the scheduled time. We will call you after exams if both testicles are not where they belong (or if your cat is actually a female).

We strongly recommend pre-operative bloodwork for pets over 5 years of age.
Call 609-267-6770 to set an appointment at least 3 business days before surgery for bloodwork.

Color

Sripped cats are are tabby. They can be orange tabby, brown tabby (the nose is brown) or grey tabby (nose is grey).

*Breed (required but “unknown” is an option)

What Breed?

Hair Length

Short Medium Long

Does this cat spend any time outside? (required)

yes no

*Friendly? (required)

*Has this pet been to our office before? (required)

Medications

Medical Information (choose at least one)

Use this space to describe health concerns

Extra Services

Highly Recommended

At-Home Pain-Relief

Buprinex

AND/ OR

Traumeel

Buprinex is a conventional pain medication used in veterinary hospitals nationwide. It is highly recommended for friendly cats. It has to be applied to the gums and therefore is not a good choice for unfriendly cats.

Traumeel is an alternative remedy (integrative, alternative or complimentary medicine) for healing and pain-relief. It is nearly tasteless so though it is also absorbed through the gums, it can be administered in a small amount of broth prior to a meal. It can be used instead of, or in addition to, buprinex.

Also Available

Vaccines & Testing

FIV/FeLV test

This is a screening test only. Positive cats will NOT be euthanized.

Rabies

Distemper (FVRCP)

Would like shot records checked

Please bring shot records with you if you want us to review them.

Pets must be at least 12 weeks old for a rabies vaccine.

Has this pet had a rabies vaccine in the past?

If you would like a 3-year vaccine, please bring a previous year's rabies certificate (even if expired). State law forces a 1-year license unless we see proof of a previous years rabies vaccine.

State law requires us to provide a 1-year rabies license for pets without a certificate to prove prior vaccination. Be sure to keep a copy of your invoice (which has the certificate on it) so that you can get a 3-year license next year.

Identification

Microchip

We use Home Again International microchips. Your pet will be registered forever. Microchips are used for identification purposes. They do NOT provide proof of ownership.

Ears, Nails

Clean Ears

Trim Nails

Ear Mite Check

Ear Mite Treatment

Worms

Fecal Exam

Please bring a stool sample.

Deworm

Hooks and Roundworm Treatment: We will supply 2 doses to be given at a 2-week interval. The first dose may or may not be given at the clinic.

Tapeworm treatment

Tapeworm looks like rice. Typically caused by fleas. there is no sense treating for tapeworms without also using a good flea product like advantage.

Please bring a fecal sample when you drop off your cat in the morning.

Flea Preventative

1 month applied 3 month supply 6 month supply

All applications of flea product will be sent home. None will be applied to your pet.

Flea product will be applied to your pet the day of surgery.

Extra Surgery

Hernia Repair

Ear Tip

Identifies feral or barn cats in a colony that have already been fixed. the tip of the left ear is removed. There is no charge for this service in thanks to the caregivers.

Prevent Licking

E-collar

Rarely needed. Also available at PetsMart.

We carry soft blue e-collars for FRIENDLY cats who's owners want one on hand just "in case."

Payment Method (required): Due at the time of pick up

Cash-5% discount Credit/Debit Card A Combination of Both

If known, how much will you be paying in cash?

Submitting your Form

NOTE: If you do not see a Thank You Notice after you click the blue “Submit" button, please go back and fill in all required fields (they will be noted) and then click “Submit" again. Once properly submitted, the form will arrive in your email