FIV & FeLV Sample Observation for Cat Owners
Veterinary & Aquatic Services Department, Drs. Foster & Smith

The American Association of Feline Practitioners has designed a form (see below) that cat owners can fill out and present to their veterinarians. This will help their veterinarians determine what testing for Feline Immunodeficiency Virus (FIV) and Feline Leukemia Virus (FeLV) may be necessary. Click here if you would like to go to a blank form you can print out and use.
FIV and FeLV Observation Form

About Your Cat:

Name: Morris

Age: 6 Years

Sex: Male

Is your cat neutered/spayed? Yes

Geographic Location: WI - Wisconsin 54501



How long ago was your last visit to your veterinarian? 2 Years

Is your cat primarily an indoor cat or an outdoor cat? Mostly indoor

Has your cat been vaccinated for FeLV? Yes

Do any of these situations apply to your cat? Please check all that apply:

Has been outside unsupervised __
Was exposed to a cat with unknown FIV/FeLV status
Was in a fight with another cat  X 
Lives in a household with other cats of unknown FIV/FeLV status
Lives in a household with a recently adopted cat __
Was a stray or obtained from a shelter

Has your cat had any of these signs of illnesses? Please check all that apply:

Weight Loss  X 
Decreased appetite
Decreased grooming __
Decreased energy or general weakness
Vomiting __
Gingivitis (red, swollen gums)  X 
Pale gums
Mouth sores __
Enlarged lymph nodes
This form was developed by the American Association of Feline Practitioners.


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