Name: Paws & Claws Animal Hospital
Address: 5333 Oleander Drive, Wilmington, NC, 28403
Telephone: (910) 399-3768

AVIAN HUSBANDRY FORM

Avian Husbandry Online Form

Please complete this form in it's entirety and click submit once finished.

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Client Name:

Patient's Name:

Phone:

Email:

Species:

Hatch Date or Age:

Sex:

Sex Determined By:

Origin:

How long have you had this bird?:

From where did you obtain this bird?:

Does this bird have a reproductive history?: If so, give details.

When did you bird last molt?:

How often has your bird been molting?:

Is your bird vaccinated? If so, give details.

Does your bird get it's wings trimmed?:

Do you have other birds or pets? If so, how many and what kind(s)?:

Have you or your bird come in contact with any other birds in the last 30 days?:

When was the last bird added to your collection?:

If your bird is ill, what symptoms have you seen? How long have these complaints existed?:

What health issues has your bird had previously?:

Has your bird received any medications in the past 30 days? If so, what medication, time of use, & dosage?:

Have you noticed any recent changes in your birds behavior?:

Have any other animals or persons in the household had an illness in the past 30 days?:

How often do you feed your bird?:

Do you use any nutritional supplements? If so, what kind?:

Seed Mixtures: (indicate brand & amount)

Pellets: (indicate brand & amount)

Fruits/Vegetables: (indicate type & amounts)

Meat: (indicate type, amount, if its fresh, frozen, or live prey)

Treats: (indicate type, brand, and amounts)

Other Foods:

What water supply do you provide?:

How is water provided?:

How often is the water changed?:

Do you use any water supplements? If so, what kind?:

Have you noticed any changes in eating or drinking behaviors? If so, give details.

Have you noticed any changes in droppings? (fecal material, urine, urates)

Where is cage/housing located? Please give details.

What is the cage made of?:

What is the size of the cage?:

What kind of bedding is used?:

What decor/furnishing are present?:

Nestbox

Perches

Swing

Rope Toys

Give details of what type of furnishings are in cage:

Are bathing facilities provided? If so, give details:

How often is cage cleaned?:

What cleaning agent(s) are used in cleaning cage?:

What percentage of the day is your bird inside its cage?:

Is your bird supervised when outside of cage?:

Does your bird have regular exposure to direct sunlight? If so, how often?

Is your bird exposed to UVA & UVB lighting? If so what brand?

What is your birds light & dark cycle?:

Does anyone in the household smoke?:

Do you use aerosolized products?:

Have there been any changes in the environment within the past three months? If so, give details.

202 Giles Ave., Wilmington, NC 28409

info@pawsclawsah.com
(910) 399-3768

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