Cat and dog resting together on a pink blanket

Cold Laser Therapy Screening & Owner Consent

In-Home Wellness Services

Before your cat’s first Cold Laser Therapy session, we want to make sure we have the information needed to provide thoughtful, safety-conscious care.

Cold Laser Therapy is a non-invasive complementary wellness service, but it may not be appropriate for every cat or every health condition. Certain medical histories or concerns may require veterinary guidance or clearance before we proceed.

Please answer the questions below as completely and accurately as possible. If anything gives us paws for concern, we’ll discuss the next step with you before your cat’s session.

Cat Parent Information

First Name *

Last Name *

Phone *

Email *

Address

Street Address *

Country

State *

City *

Postal Code *

Tell Us About Your Cat

Cat Name *

Date of Birth or Approximate Age *

Veterinarian Name

Veterinarian Phone Number

What area(s) of your cat’s body are you interested in supporting with Cold Laser Therapy? *

Health & Laser Screening

Please answer every question below. A “Yes” response does not automatically mean your cat cannot receive Cold Laser Therapy. We may contact you for additional information or request veterinary guidance or clearance before proceeding.

Has your cat ever been diagnosed with cancer, a tumor, or a mass that has not yet been evaluated? *

Yes

Is your cat currently pregnant or possibly pregnant? *

Yes

Not Applicable

Does your cat currently have any active bleeding or a condition involving uncontrolled bleeding? *

Yes

Does your cat have a thyroid condition or any known concern involving the thyroid area? *

Yes

If yes, please explain the thyroid condition or concern.

Has your cat ever been diagnosed with lymphoma?

Yes

Is your cat currently taking immunosuppressive medication?

Yes

Is your cat still young and growing or has your veterinarian ever advised caution around growth plates or developing bones?

Yes

Does your cat have any eye condition, eye injury, or sensitivity that we should know about?

Yes

Has your veterinarian ever told you that your cat should avoid laser therapy?

Yes

Is there anything else about your cat’s health that you feel we should know before proceeding with cold laser therapy?

Yes

If yes, please explain any other health concerns.

Is your cat currently under veterinary care for the condition or area for which you are seeking Cold Laser Therapy? *

Yes

Not Applicable, General Wellness Support

If yes, please briefly describe your veterinarian’s current recommendations or treatment plan.

Is there anything else you would like us to know about your cat before their wellness session?

Owner Acknowledgment & Consent

Owner Acknowledgment and Consent *

I confirm that the information I have provided is accurate to the best of my knowledge.

I understand that Cold Laser Therapy is a complementary wellness service and is not a substitute for veterinary examination, diagnosis, treatment, or emergency care.

I understand that Cold Laser Therapy may not be appropriate for every cat, condition, or treatment area.

I understand that Pink Paws & Purrs Cat Care LLC may postpone or decline a Cold Laser Therapy session or request veterinary guidance or clearance when a health concern or potential contraindication is identified.

I agree to notify Pink Paws & Purrs Cat Care LLC of significant changes to my cat's health, medications, diagnosis, or veterinary recommendations before future Cold Laser Therapy sessions.

I understand that individual responses to complementary wellness services vary and that no specific result or outcome is guaranteed.

I have read and understand the information above and consent to Cold Laser Therapy being provided to my cat.

By checking this box, I consent to receive non-marketing text messages from Pink Paws & Purrs Cat Care LLC regarding my inquiry, appointments, scheduling, service updates, and other information related to services I have requested. Message frequency varies. Message and data rates may apply. Text HELP for assistance. Reply STOP to opt out. Consent is not a condition of purchase. See our Privacy Policy at pinkpawsandpurrs.com/privacypolicy.

Cold Laser Consent Signature *

Clear

Cold Laser Consent Date *