Small Mammal History
Pet's name
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Breed/Species
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Age or date of birth
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Sex
How long have you had this pet?
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Where did you obtain this pet?
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Any reproductive history?
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How often is your pet handled?
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Do you have any other pets? Please list
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Have you or your pet had any contact with another of its kind within the last 30 days
What is the primary complain or what signs have you noticed?
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How long have these problems been present?
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What health problems has your pet had previously?
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Has your pet received any treatment for these problems in the last 30 days? If yes, details
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Have you noticed any change in behaviour? Explain
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What type of enclosure is used for this pet?
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Enclosure size and material it is made of?
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Type of bedding used
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What furnishings or décor are present?
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Is this enclosure indoors or outdoors?
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How often is the enclosure cleaned and what cleaning products are used?
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Is your pet housed with others of its kind? Details
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Is your pet allowed to roam through the house?
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Have there been any changes to the pet's environment within the last 3 months? If yes, details
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List all food/treats your pets eats & their amounts:
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How often do you feed your pet?
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Where do you obtain your pet's food?
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Do you give any supplements? Details:
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Is water readily available?
How is water provided?
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Have you noticed changes in food/water intake? Details:
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Have you noticed any changes in urine/feces? Details
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Does your pet chew on things regularly?
What do you give your pet to chew on?
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Has your pet ever had its teeth trimmed or clean?
Additional comments:
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Please feel free to send pictures of your pet's enclosed or any visible health concernts to southportah@gmail.com prior your appointment.
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