Avian History Form
What type of food does your pet eat (pellets/seed/fruit/vegetables/other)? Please include brand for pellets/seed.
How long have you owned this bird?
Source of bird?
Bird is kept in:
Free in house
Any other birds kept in the same cage, aviary or flock?
Please list other birds in the household:
Please list other pets in household:
What type of substrate is used in the cage?
How frequently is the substrate changed?
If so, please explain. Include medication names, dosages and length of treatment.
How frequently is the entire cage/coop cleaned?
How frequently are the food and water dishes cleaned?
Do you use vitamin or mineral supplements?
If so, what type and how often?
How often is you bird bathed/misted?
Where in the home is the bird's primary habitat located?
Has your pet received any home treatments or veterinary care previously?
Has your pet had previous labwork?
If so, where was the labwork performed?
What is the primary reason for your pet's visit today and what concerns do you have?
Should be Empty: