Small Mammal History Form – Kensington Bird & Animal Hospital

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Small Mammal History Form

Name*
First Last
Pet's Name*
First Last
Species*
Gender*
Is your pet:*
Age (if known)
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
- Wood enclosure
- Free range
- Multi-level enclosure
- Specific room
- Other
If other, please specify:
Does your pet live indoors or outdoors?*
- Indoors
- Outdoors
Does your pet have a cage mate?*
- No
- Yes
What type of substrate do you use?*
- Newspaper
- Paper towel
- Carefresh
- Wood shavings
- Tile
- Carpet
- Rubber
- Other
If other, please specify:
How is water offered?*
- Bowls
- Bottles
- Other
If other, please specify:
What is your pet's diet? (pellets, hay, etc.)*
How much food is given and how frequently?*
Has the small mammal been seen by another veterinarian?*
- Yes
- No
If yes, please include name and phone number of veterinarian:
Please upload photo of enclosure (optional):

Contact.

977 Farmington Ave
Kensington, CT 06037

Phone: (860) 828-7736

Fax: (860) 829-0594

Hours.

Monday – Friday
8:00am – 5:00pm

Saturday
8:00am – 12:00pm

Sunday
Closed

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About Us
Emergency Care
Clinic Forms
- Forms
- Forms
Services
Pet Health
Contact Us
- Make An Appointment
Wildlife & Disease Outbreaks