Dermatologic HistoryFeline Dermatology History To help expedite your visit, please fill out this form and we will get in touch with you shortly.Owner's Name First Last E-mail PhoneCat's NameCat's AgeBreedSexMaleFemalePrimary concerns about your cat's skin:When was the problem was first noticedHow did the problem start: Suddenly GraduallyDoes your cat itch or lick excessively or over-groom? Yes NoWhen? Constant Sporadic During the night onlyWhat time of year most itchy? Spring Summer Fall Winter Year aroundWhat part(s) of your cat is most itchy?Where does your cat spend most of his/her time?What other pets live in your household?Describe your pet's diet (including name of food, snacks & treats)What flea control do you use and how often? Do all the pets receive the same flea control at the same intervals?How often do you bathe your cat?What medications is your cat taking at this time?What other health problems does your cat have?What previously prescribed medications have been of benefit?Please share any additional information that you think is important.NOTE: BE SURE TO BRING THE PREVIOUS MEDICATIONS, PILLS, OINTMENTS, EAR CLEANERS, SHAMPOOS (EVEN IF EMPTY) TO THE CONSULTATION.
