Avian History Form

Owner's Name*

First Last

Pet's Name*

First Last

Breed (if known)

Color

Gender*

Age (if known)

Is your pet:*

Where did you get your pet?*

If other, please specify:

What type of enclosure?*

If other, please specify:

What type of perches do you use? (check all that apply)*

If other, please specify:

Does your pet have a cage mate?*

What type of substrate do you use?*

If other please specify:

How is water offered:*

Do you cover the cage at night?*

How many hours of sleep?*

Diet:*

If pelleted diet, what brand?

Does your bird bathe? How?

Has your pet been tested for the following?

Does your bird have any other health issues?

Upload photo of enclosure: