Client Name* First Last Pet's Name*Species*Age** Pet Breeder Background InformationLength of time owned*Where acquired?* Breeder Pet Store How often is pet handled?* Daily Occasionally Never Character of feces*HubandryHoused Indoors/Outdoors?*Where is cage located?*s pet allowed to roam free in the house?* Yes No Type of Caging*Size of Caging*Galvanized?* No Yes Unsure Cage Substrate?*How often is cage cleaned?*What type of disinfectant is used when cleaning cage?*Types of toys/furniture offered?*Litter Box Offered?*NutritionTypes Of Food OfferedPellets?* Yes No If yes, what brand? Amount fed/frequencySeed?* Yes No If yes, what brand? Amount fed/frequencyFruits / Veggies?* Yes No If yes, what brand? Amount fed/frequencyHay?* Yes No If yes, what brand? Amount fed/frequencyOtherTypes of Supplements/Treats offered:*Water Source*How Often Is Water Changed?*Any Other Pets?* Yes No If Yes, SpecifyDo Other Pets Interact With This Pet?* Yes No If Yes, SpecifyAre Pets housed Together Or Singularly*If not housed together, where are other pets located?*Any new additions to the pet population?* Yes No If Yes, SpecifyWere the new additions properly quarantined separate from rest of pet population before introduced?*Past Medical History/Problems:*Current Presenting Problems:*Duration of Problem:*EmailThis field is for validation purposes and should be left unchanged.
