New Client Drop Off Client Name Owner Name * Phone number where you can be reached today Email * Reason for today’s visit * Please describe the events leading up to today’s visit including time of onset and duration of symptoms. * When was your cat’s last meal? What type of food does your cat eat? Please list any medications your cat is taking. (Including time given and dosage.) Has your cat been seen by the Cat Clinic before? yes no (Please fill out a New Client Questionnaire and arrange for previous medical history to be provided to the clinic if you or your cat are new to the Cat Clinic of Plymouth) Check one: Please perform appropriate diagnostics and treatments after examination of my cat. Please call the above number to inform me of examination findings and provide an estimate of diagnostics and treatments. Please update my cat’s vaccinations if needed. In admitting my cat to the Cat Clinic of Plymouth, I authorize the veterinarian and their support staff to administer treatments and/or perform diagnostic or surgical procedures as deemed necessary. I understand that all fees incurred are to be paid at the time of service. * yes no Captcha If you are human, leave this field blank.