Mazomanie Animal Hospital

704 Emily Rd
Mazomanie, WI 53560

(608)795-4242

www.mazoanimalhospital.com

Kitten Check-In Form

Thank you for scheduling a New Kitten Exam! We hope your are enjoying your new kitten!
We are here to help you get off on the right paw.

At each kitten visit (usually at 8,12 and 16 weeks of age), we will be examining your kitten for health concerns as he/she rapidly changes and grows.
We will also review our recommendations to prevent, manage, or treat many common behavioral and medical problems common to cats. 
These recommendations are specifically outlined in the New Kitten Handout you will be provided at your kitten's first visit.  

Please fill out the form below to help us best serve you and your kitten during their visit.

Thank you for your time!

Kitten Check-In Form

Email (This should be the main email you would like us to use for your account) (required)

Kitten's name (required)

Owner's Name (That account is under in our system) (required)

Who will be bringing your kitten to their appointment?

What is the best contact number for that person during the scheduled appointment time?

Address
Street Address
City
,		State / Province
Zip / Postal Code
Phone
Phone TypePhone Number
Is this a cell phone that can accept text message reminders from us?

Yes
No


To help us focus on your particular areas of concern at today's visit, please answer the following questions.
Have you personally cared for and raised a young kitten in the last 5 years?

Yes
No


Are there any other pets in the household?

Yes
No


How long have you had this new kitten?

Where did you get this kitten?

Humane society / shelter
Breeder
Stray
Rescue Organization
Other (Please describe in Other Comments box below)


Does your kitten have and MEDICAL problems you are concerned about today?

Itchy ears or skin
Stools abnormally soft or diarrhea
Poor appetite
General nutrition or feeding questions
Other (Please describe in Other Comments box below)


Are you experiencing any of the following common kitten TRAINING problems?

Litter Box Training
Climbing / nail trimming
Overly aggressive play
Other (Please describe in Other Comments box below)


Are you interested in learning about FeliScratch, a product that encourages and redirects your kitten to scratch on a scratching post?

Yes
No


Would you like your kitten's nails trimmed today? (There is a fee for this)

Yes
No


Other Comments / Questions


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