Small Mammal History Form

Date*
Date Format: MM slash DD slash YYYY
Pet's Name:*
Species/Common Name:*
Length of Ownership?*
Where did you acquire your pet?*
Age/Approx DOB*
Enclosure size:*
Bedding type:*
How often is bedding changed?*
How much time do they spend out of the cage?*
Are there any cagemates?*
- Yes
- No
How often do you handle your pet?*
What is your pet's diet? (e.g. seeds, pellets, hay, fresh fruit/veggies, brand names)*
Does your pet eat all of what you feed?*
Do you give any supplements?*
Presenting complaint or reason for exam:*
Date of last exam:*
Existing health problems, current medications, etc:*

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