Drop Off Appointment Form

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Please fill out the following form prior to bringing your cat for a drop off appointment.
This will ensure a faster check-in process and and allow us to tailor your cat's stay for the best possible experience for you and your cat. Please note, filling out this form does not confirm an appointment for medical care. Please contact our office to schedule your appointment to ensure availability.

* Indicates required field

Name *

First

Last

Best Contact Number Day of Appointment *

Secondary Contact *

Secondary Contact Number *

Is your cat a new patient at the Cat Clinic? *

Yes (please fill out the New Patient Form) No

Is your cat currently taking any medications? *

Yes No

If so, please list medication, dose, and frequency of administration: *

For example: Revolution Plus topical once monthly, or Methimazole 5mg 1/2 tablet twice daily

Does your cat have any known allergies? *

Yes (please note below) No

Allergies: *

Is there any other pertinent medical history we should know about? *

Such as previous injuries or surgeries, chronic illnesses, etc.

Cat's Name *

Appointment Reason *

Please Describe Reason for Visit *

ie annual exam, new kitten visit, vomiting and diarrhea, or weight loss etc

Is your cat experiencing any of the following: *

Vomiting Diarrhea Coughing Sneezing Congestion Anorexia or Decreased Appetite None of the Above

How long has your cat been experiencing these symptoms? *

When did your cat last eat? *

Is there anything else you would like to discuss with the Doctor today? *

Comment *

Your cat will be admitted to the clinic for routine care or the evaluation of an illness. In order to prevent incorrect assumptions and miscommunications, we require authorization to initiate diagnostic testing and treatment of your cat, as well as to obtain acceptance of your financial responsibility for the care provided. Diagnostic tests and treatments for a sick patient may include laboratory analysis, radiographs, treatments or medications, the cost of which can vary widely depending on the nature of the procedures needed. Authorization to treat means accepting the financial responsibility to pay the total bill in full upon the cat's discharge from the hospital. We do not offer payment plans. *

I am at least 18 years old, and I am the owner / duly authorized agent for the owner of the animal described herein. I authorize The Cat Clinic of Asheville to start diagnostic testing and treatment on my cat based on the estimate provided at the time of drop off. The doctor may choose pain management if necessary before any other diagnostic tests or treatments. The doctor will call me as soon as reasonably possible with results of any tests and the final treatment plan. I understand that all payment is due upon my cat being discharged from the clinic including additional tests or treatments verbally agreed upon in addition to the initial estimate.

Submit

Cat Clinic of Asheville
49 Haywood Rd
Asheville, NC 28806
828-645-7711
catclinicofasheville@gmail.com

Monday 8:00-5:00
Tuesday 7:30-7:00
Wednesday 8:00-5:00
Thursday 7:30-7:00
Friday 8:00-5:00
Closed daily 12:00-1:00 for lunch