Small Mammal Questionnaire

Patients' Names:

Your Full Name*:

Email*:

Your pet's species*:

Length of time owned*:

Pre-ownership History*:

When was your pet last vaccinated? (rabbits/ferrets)*:

What is your pets normal feeding regime?*:

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

Any supplements provided to pet (what, when and how provided?)*:

When did your pet last pass faeces? Was it normal? (please describe)*:

When did your pet last urinate? Was it normal? (please describe)*:

Describe your enclosure*:

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

What is the substrate used?*:

How often is the enclosure cleaned?*:

Is he/she housed solitary?*:

Yes
No

If no, how are the others in the collection?:

Does your pet go outside? (proportion of time spent outside)*:

What is his/her normal activity level? (has this changed?)*:

What is his/her temperament and demeanour? How is he/she now?*:

For ferrets: Is this animal a working ferret? If so, what type of work do they do?:

What is your main concern today?*:

Have you given your pet any medications/treatment? (what and when?):

Security Question*: