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Location For Visit * --- Select Hospital Location --- Tucson, AZ Phoenix, AZ Mesa, AZ Denver, CO Portland, OR
Your Pet's Name *
Color *
Where and when did you acquire your pet? *
Do you have any other pets? If yes, please specify: *
Please describe what type of cage/environment your pet lives in: *
What kind of bedding do you use on the bottom of the cage? *
How often is the cage/environment cleaned? *
Method/frequency of cleaning food and water dishes: *
Describe any cage accessories (toys, bowls, etc): *
Has your pet's environment (cage, toys, etc) changed recently? If yes, please describe: *
Are there any other pets sharing the cage? If so, please describe: *
If your pet is a chinchilla, do they get dust baths? If yes, what frequency? *
If your pet is a ferret, do they use a litterbox? *
What foods do you feed your pet? *
Do you give any vitamin supplements? If so, what type? *
What, if any, treats are offered? How often? *
what When
Any recent diet changes or new foods? If yes, please describe *
How is water offered (sipper bottle, bowl, etc)? *
Please list any previous medical problems: *
Has your pet ever been hospitalized or had surgery? Please describe: *
Have there been any changes in your pet's urine or defecation? Please describe: *
Does your pet have any behavior problems? Please describe: *
Please list any current or recent medications: *
Has your pet been vaccinated? When and where? *
Is your pet bathed or groomed regularly? *
Does your pet get nail trimming? *
Any other comments or information we should know? *
