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Avian Health History Questionnaire

Avian Health History Questionnaire

  • breed of bird/scientic name
    Please check all that apply.
  • Please give details on complaint today, signs you have noticed and how long these signs have been present. Any previous health issues? Any other animals or humans had health issues in last 30 days?
  • DIET:

    Please fill out information today to the best of your knowledge.
  • Please specify what types of food are eaten and amount of each. (seed mixtures/brand, pellets brand, fruits & vegetables, meat)
  • Please specify what type of treats and how much you are giving.
  • fecal consistency, change in urine
  • CAGE ENVIRONMENT

  • What type of toys, bedding and furnishings in cage?
  • What types or baths? Soap? Spray bottle?
  • Inside? Outside?
  • How long is your bird covered and uncovered?