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Date of Birth / Approximate Age
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Breed
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Gender
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Has your cat been spayed or neutered?
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Has your cat been declawed?
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Does your cat go outside?
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When was your cat last seen by a veterinarian?
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Previous Veterinary Practice
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Vaccine History Information
Rabies Vaccine - Last Given
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Rabies Vaccine - Next Due
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Distemper Vaccine - Last Given
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