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Services
Wellness and Life Stage Exams
Pet Dental
Urgent & Emergency Care
Surgery
Pet Boarding
Ultrasound
Digital Radiography
View All Services
Wildlife
Pet Owners
Online Forms
Apply For Care Credit
Online Store
RX Refill
Download Our App
Education
About Us
Meet Our Team
Online Store
Contact Us
Download Our App
24/7 Emergency Care
Emergency & Urgent Care
Book an Appointment
Avian Questionnaire
Patient Information
Pet Name
(Required)
Species
(Required)
Approximate Age
(Required)
Sex
(Required)
Male
Female
Unknown
How long have you owned this pet?
(Required)
Where did you get this pet?
(Required)
Medical History
Has your pet been to a vet before?
(Required)
Yes
No
Please note any previously diagnosed medical concerns for your pet below
Husbandry / Care
Please bring a picture of your pet's enclosure to your appointment
Is your bird housed alone?
Yes
No
Are there other birds in the home?
Yes
No
Do you keep your bird’s wings trimmed?
Yes
No
Do you bathe your bird?
Yes
No
If you bathe your bird, describe how do you bathe it (spray bottle, sink, shower)?
Has your bird ever laid an egg?
Yes
No
N/A
Housing
Does your bird live indoors or outdoors?
Indoors
Outdoors
Has both indoor and outdoor housing
What type of perches are in the cage?
Natural wood
Rope
Wooden dowels
Sandpaper
Other
Describe your bird’s housing set-up. Include approximate size, construction materials & a diagram if applicable.
Feeding
List ALL types of food (seed, pellets, nuts, fruit, vegetables, etc) items given including quantity and frequency
Does your pet drink from a bowl or bottle?
Bowl
Bottle
Other
Please list any supplements/vitamins
Any other comments or concerns?
CAPTCHA
Emergency & Urgent Care
Emergency & Urgent Care
Book an Appointment
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