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Avian History Form
Owner's Name
*
First
Last
Pet's Name
*
First
Last
Breed (if known)
Color
Gender
*
Male
Female
Unknown
Age (if known)
Is your pet:
*
Wild caught
Domestically bred
Imported
Where did you get your pet?
*
Breeder
Pet Store
Friend/Family
Rescue
Found/caught
Other
If other, please specify:
What type of enclosure?
*
Mesh/wire cage
Aviary
Free range
Coop
Specific room
Other
If other, please specify:
What type of perches do you use? (check all that apply)
*
Natural branches
Plastic
Metal
Rope
Sand
Stone
Paper
Other
If other, please specify:
Does your pet have a cage mate?
*
Yes
No
What type of substrate do you use?
*
Newspaper
Paper towel
Corn cob
Sand paper
Other
If other please specify:
How is water offered:
*
Bowls
Bottles
Do you cover the cage at night?
*
Yes
No
How many hours of sleep?
*
Diet:
*
Pellets
Seed Mix
Veggies/Fruit
Table scraps
If pelleted diet, what brand?
Does your bird bathe? How?
Spray bottle
Shower
Has your pet been tested for the following?
Psittacosis
PBFD (beak and feather disease)
Fecal Analysis
PDD
Does your bird have any other health issues?
Has the bird been seen by another veterinarian?
Yes
No
If yes, please include name and phone number of veterinarian:
Please upload photo of cage setup (optional):
About Us
Our Team
Our Videos
Policies
Emergency Care
Clinic Forms
Forms
Schedule an Appointment
New Client Registration Form
Reptile History Form
Prescription Refill and Food Order Request Form
Avian History Form
Small Mammal History Form
Forms
Amphibian History Form
Fish History Form
Urine Drop Off Form & Collection
Prescription Waiver Form
Dermatology History Form
Rabbit RHD waiver (1st time vaccine)
Rabbit RHD Waiver Yearly Booster
Services
Pet Health
Pet Health Library
How-To Videos
Care Sheets
Bearded Dragons
Herbivore Greens List
Contact Us
Make An Appointment
Wildlife & Disease Outbreaks
Avian Influenza
Injured Wildlife
Rabbit Hemorrhagic DiseaseĀ