Avian Questionnaire

Patients' Names:

Your Full Name*:

Email*:

Your pet's species*:

Gender of pet*:

Length of time owned*:

Pre-ownership History*:

Has your pet had any disease testing previously and what were the results?*:

What is your pets normal feeding regime?*:

When did your pet last eat normally?*:

When did your pet last eat and what did they eat?*:

Any supplements provided to pet (which ones, how often and how provided?)*:

What type of enclosure is he/she housed in?*:

If you would like to upload a photo of the enclosure, please do so:

How often is the enclosure cleaned?*:

What is the substrate used?*:

Do you have UV provisions?*:

Yes
No

If yes, what UV provision do you have and when was bulb last changed?:

Is he/she housed solitary?*:

Yes
No

If not solitary, how are the others in the collection?:

If not solitary, does he/she have direct access to any others in collection?:

Does your pet have outside access?*:

Yes
No

What is his/her normal activity level?*:

What is his/her normal routine?*:

How much out of cage time does he/she have and what do they do during this time?*:

Is the bird free flighted (inside/outside, supervised/non-supervised?)*:

What is his/her demeanour and temperament normally?*:

Any new birds/animals in collection (when and where acquired from?):

What are you concerned about with your pet today and how long has it been going on?*:

Have you given any medications/treatments? :

Security Question*: