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General Information:
General Information:
Client Name
Email
Date
Appointment Time
Pet Name
Species/Breed
Sex
Male
Female
Unknown
DOB or Age (rough estimate if exact unknown)
Background Information
Background Information:
Length of time owned
Previous treatments
Where was the pet acquired?
Breeder
Pet
store
Other
Was the pet caught in the wild or bred in captivity?
Wild
caught
Captive
bred
Housed indoors or outdoors?
Indoors
Outdoors
Is pet allowed free roam in the home?
Yes
No
How often is pet handled?
Daily
Occasionally
Never
Other pets
Yes
No
If yes, please specify.
Fecal output
Normal
Diarrhea
None
Urine output
Normal
Abnormal
Any recent additions of exotic mammals to the household?
Mammal housed with other animals?
Yes
No
If yes, please specify.
Husbandry
Husbandry:
Type of enclosure
Size of enclosure
Where is the cage located?
Type of cage furniture
Cage substrate
How often is the cage/substrate cleaned?
Type of disinfectant used to clean the cage?
Nutrition
Nutrition:
Type of food and brand offered
Ratio of food fed (ex: 50% hay, 50% pellets)
Frequency of feedings
Last feeding
Appetite
Water source
Frequency changed
Medications given
Supplements given
Guinea Pigs-Vitamin C Supplement
Yes
No
Supplement Type
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