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  • CHOC Online

    Treats and Tidbits Quarterly eLetter

    • New Client Form

    Download Printable Version Download Printable Version

    WHO SHOULD USE THIS FORM:

    If you are new to Cat Hospital of Chicago, or if you are bringing in a new patient whom we've not yet seen, please complete the following "New Client Information Form" and submit. This will help to expedite your visit to Cat Hospital of Chicago (and I'm sure your cat will appreciate spending a few less minutes visiting us!)

    We ask that you bring a fresh stool sample(no more than 12 hours old) from your cat(s) to your first visit with us as well so that we can examine it microscopically for intestinal parasites.

    *=required

    *Owner's Name:

    Spouse/Other's Name:

    *Address:

    *City:

    *State:

    *Zip:

    *Owner's Home Phone:

    Owner's Work Phone:

    Owner's Cell Phone:

    *Owner's E-mail Address:

    Spouse/Other's Work Phone:

    Spouse/Other's Cell Phone:

    *Owner's Employer's Name:

    *Owner's Employer's Address:

    Spouse/Other's Employer's Name:

    Spouse/Other's Employer's Address:

    *Best time and method of reaching you’?

    TIME:


    Please indicate phone/fax number or email:

    * In an EMERGENCY, who should we call?

    WHO:

    NUMBER:

    How did you hear about our hospital?

    Please check all that apply

    Hospital Sign/ Drive by

    Individual; Someone we may thank?
     

    Individual's Name:

    Search Engine

    Cat Hospital of Chicago website

    Facebook

    Online research/reviews

    Yellow Pages

    Other:

    Would you be interested in having your cat microchipped &/or getting more information on this service?

    Yes

    No

    My cat already has a microchip

    We will gladly prepare an estimate if you desire. Please ask the receptionist, technical support staff member, or the doctor.

    Additional Comments:

    Click tab to enter info for each of your cats (up to three).

    • Cat "A"
    • Cat "B"
    • Cat "C"

    Cat Hospital of Chicago is your source for the best cat veterinarians and veterinary equipment in Chicago. Our cat doctors bring years of experience and a lifetime of compassion to our cats-only facility. We use state-of-the-art equipment, and our cat veterinarians receive continued training and education, making Cat Hospital of Chicago the best cat veterinary facility in Chicago. For more information about Cat Hospital’s cat doctors, click here.