Online Form

Avian History Questionnaire

Complete your avian history questionnaire form online from any device at any time before your visit.

Avian History Questionnaire

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

Client Name(Required)

First Last

Pet's Name(Required)

Date In(Required)

MM slash DD slash YYYY

Expected Date Out(Required)

MM slash DD slash YYYY

Present Environment

How do you keep your bird?(Required)

Cage

Aviary

Free in home

Indoors

Outdoors

What is the size and location of your bird's enclosure?(Required)

Are there other birds in the same cage or aviary?(Required)

Yes

Have you had any other birds on the premises, either past or presently?(Required)

Yes

Are any of those birds sick?(Required)

Yes

Have any of them died?(Required)

Yes

If yes, please explain

Do you have any other pets in the home or yard?(Required)

Yes

If yes, please list them

List the toys you have available to your bird(s)(Required)

What do you use on the bottom of the cage (substrate)?(Required)

Can your bird reach it?(Required)

Yes

How often do you change it?(Required)

How often and what method do you use to clean your bird's water and food receptacles?(Required)

Sleeping Habits:

How many hours of darkness does your bird get?(Required)

Are they...(Required)

Covered

Uncovered

In sleeping cage

In regular cage

Is there any activity around the cage when your bird(s) is sleeping?(Required)

Yes

If yes, please explain:

How much exposure to UVB does your bird get?(Required)

Direct sunlight

UVB Bulb

How many hours?(Required)

What is your bird's current diet?(Required)

Pellets

Seeds

Fresh Foods

Other

What brand(s)?(Required)

How much food do you offer?(Required)

How much food does your bird consume?(Required)

How often is your bird's food replaced?(Required)

How do you bathe your bird?(Required)

Medical History

Does your bird have any previous illnesses or injuries?(Required)

Yes

If yes, please explain:(Required)

Has your bird taken any medications in the past?(Required)

Yes

If yes, please explain:(Required)

Is your bird currently taking any medications?(Required)

Yes

If yes, please explain:(Required)

Has your bird had any vaccinations?(Required)

Yes

If yes, please explain:(Required)

Do you trim your bird's wings?(Required)

Yes

If yes, what method?(Required)

When was your bird last examined?(Required)

Reproductive History

If your bird is female, has she laid any eggs?(Required)

Yes

If yes, when was the last clutch?(Required)

How often does egg laying occur?(Required)

How many eggs does your bird typically produce?(Required)

Are your bird's eggs fertile?(Required)

Yes

If yes, are offspring viable when hatched?

Yes

Please describe any concerns with your bird's reproductive health

Have A Question?

Please use the information below to contact us. A member of our team will be in touch soon!



Contact

P: (610) 948-1014
E: contact@royersfordvet.com



Location

850 Main St. Royersford, PA 19468
Our parking lot is located off 9th Street.

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Opening Hours

Mon & Wed : 8.00 am – 6.00 pm
Tues & Thurs: 8.00 am – 7.00 pm
Fri: 8.00 am – 5.00 pm
Sat: 8.00 am -12.00 pm

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