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CONTACT
information
OWNER’S INFORMATION Name: Address:
____________________________________________
PET’S
information
Name: _______________________________________________ Gender: ______________________________________________ o Spayed
o Neutered
___________________________________________
Breed: ________________________________________________
City _______________________State_____Zip Code__________
Date of Birth: __________________________________________
Home Phone: _______________________________________
Height: ___________________ Weight: _____________________
Cell Phone: (_________)______________________________
Registration #: __________________________________________
Work Phone: (_________)_____________________________
Registered Name: ______________________________________
CAT HEALTH RECORDS keeping track of your pet’s health
Sire’s Reg. #: ___________________________________________
VETERINARIAN’S INFORMATION Name:
____________________________________________
Address:
__________________________________________
City _______________________State_____Zip Code__________ Phone:
(_________)_________________________________
Sire’s Name: ___________________________________________ Sire’s Breed: ___________________________________________
“Your Pet’s Photo”
Dam’s Reg. #: _________________________________________ Dam’s Name: _________________________________________ Dam’s Breed: _________________________________________
PET’S IDENTIFICATION Microchip ID Number: ___________________________________
EMERGENCY CONTACT INFORMATION Name:
____________________________________________
Relationship: Phone:
_______________________________________
(_________)_________________________________
Emergency #: (_________)____________________________
License Number: _______________________________________ Collar Color: ___________________________________________ Identifying Markings: ___________________________________ _____________________________________________________ _____________________________________________________
SPECIAL MEDICAL INFORMATION GROOMER’S INFORMATION
Diet: _________________________________________________
877-813-7387 | www.PetSupplies4Less.com Name: __________________________________
Name:
____________________________________________
_____________________________________________________
Phone:
(_________)_________________________________
_____________________________________________________
Date of Birth: _____________________________
Collar Size: __________________________________________
Allergies: _____________________________________________
Last Shampoo: _______________________________________
_____________________________________________________
Breed: ___________________________________
Last Bath: ____________________________________________
_____________________________________________________
Comments:
________________________________________
Medical Conditions: ____________________________________
__________________________________________________
_____________________________________________________
__________________________________________________
_____________________________________________________
Sex: _____________________________________ Markings: ________________________________ Veterinarian: _____________________________
VACCINATION
FECAL/DEWORMING
history
Dog & Puppy Deworming Guidelines
2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 years
FIP
1 year
Leukemia
wks
Chlamydia
wks
Calcivirus
wks
Rhinotracheitis
wks
Panleukopenia
wks
Date
Rabies
Age
Initial deworming treatment 2, 4, 6, 8 & 12 wks. If parasite control not included have fecal test 2-4 times per year and treat accordingly.
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Age
Date
Product | Results
wks wks wks wks wks
HEARTWORM PREVENTION Begin heartworm treatment from 6 - 8 weeks of age. Annual Heartworm testing recommended. Age
Date wks wks
Product | Results
MEDICAL DATE
RESULTS
notes
