Guinea Pig Lifestyle

PREVIOUS CONDITIONS

Has your pet had any previous conditions, operations or problems (including dental or gastrointestinal problems)? If yes, please describe:

Is your pet currently on any medications? If yes, please list the name, dose, and frequency:

Has your pet been on any previous medications? If yes, please provide the name and frequency of doses:

DIET

This section is VERY important. Be as accurate as possible. What amount of your pet's diet consists of the following (please describe what the animal actually eats, not what is offered).

How often do you change your pet's food?:

Amount of hay and type (Timothy, Alfalfa, etc.):

Amount of pellets, brand and type (Timothy, Alfalfa, etc.):

Amount of seeds, brand and type:

Amount of fruits/vegetables and type:

What (if any) treats do you give your pet (brand and amount)?:

Is the food or water supplemented with vitamins? If yes, what brand and frequency?:

Please describe any other recent changes to your pet's diet:

ENVIRONMENT

Where is the animal kept?*:

What material is used to line the bottom of the cage/litter pan?:

Is the animal kept in a cage with other animals?*:

Yes
No

If yes, how many cage mates are there? What sex are the cage mates? And are the cage mates spayed/neutered?:

Please list all other pets in your household:

Have there been any new pets (within the past six months) placed in the animal's cage? If yes, please describe:

How much time does your pet spend outside of the cage?:

Is your pet supervised when it is out of the cage?:

Does your pet chew on carpet or other objects/materials when outside of the cage?:

List any recent changes in your pet's environment:

REPRODUCTIVE: Has this pet been bred before? :

Yes
No

Additional comments or questions:

Security Question:

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY:

Guinea Pig Lifestyle

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CLIENT INFORMATION

PATIENT INFORMATION

ACTIVITY

PREVIOUS CONDITIONS

DIET

ENVIRONMENT

Guinea Pig Lifestyle

Which practice would you like to register with?

CLIENT INFORMATION

PATIENT INFORMATION

ACTIVITY

PREVIOUS CONDITIONS

DIET

ENVIRONMENT

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