Name *

Email *

Please describe the main reason for bringing your pet in for an exam. Include any observed symptoms or changes in behavior that you’ve noticed. *

Have you attempted any treatments or interventions for your pet’s condition? *

Yes
No

Please provide details about the treatments, their duration, and their impact on your pet’s condition. *

Are there any past health concerns or diagnoses that your pet has experienced? This could include any chronic conditions, surgeries, or ongoing medications your pet has received. Please provide as much information as possible. *

How long have you had your pet? *

Where did you get them from? *

Are they vaccinated? (ferrets only)

Do you have any other pets in the household? *

Has your pet had any contact with other animals in the past thirty days? *

Has anyone, human or animal, been sick with similar symptoms in the last thirty days? *

What foods do you offer your pet? *

How often and how much does your pet eat? *

Is your pet on any medications or supplements? *

What does your pet’s cage setup consist of? (e.g., substrate, cage size) *

Where is your pet’s cage located? *

You are welcome to take photos of your pet’s cage setup, foods, medications and supplements. You can then choose from the following options:

1. Bring the questionnaire and photos to the appointment: you can bring the completed questionnaire and the photos with you to the appointment. Our veterinary team will review them during the examination.

2. Email the questionnaire and photos: If you prefer, you can email the completed questionnaire and the photos to us at frontdeskhpmc@gmail.com. Please send the email at your soonest convenience, preferably before the appointment. Our team will review the information to ensure we have a comprehensive understanding of your pet’s care before the visit.

Thank you!

We appreciate your cooperation in providing us with this valuable information, as it will assist us in delivering the best possible care to your beloved pet. If you have any questions or need further assistance, feel free to contact us at
205-772-3288.

Small Mammals Exotic Questionnaire