Avian History Form - Page 2

Present Environment

Bird is kept in a: Cage Aviary Bird stand in the house
Wings trimmed: Yes No

Other birds in the same cage or aviary: Yes No If yes, please list:

List other birds on the premises, indoors and outdoors:

Are any of those birds sick: Yes No Have any died: Yes No
If yes, please give details:

List other pets in home:

List toys available to the bird:

What do you use on bottom of cage:
Can the bird reach it: Yes No

Bird is kept: Indoors Outdoors
If indoors: In a seperate room With the family

Frequency of cage cleaning:
Method/frequency of cleaning food/water receptable:

Please print this page out and bring it with you on the day of your appointment.

Click here to go to page three of Avian History Form