Rabbit & Rodent

Instructions: An accurate history of your pet is extremely important. We would appreciate your cooperation in providing us with the following information. Please check the appropriate boxes or use the spaces provided. Thank You.

Gender
Spayed/ Neutered
Is the animal kept in a cage with other animals?
Is your pet supervised when it is out of the cage?
Do you supplement your pet with any vitamins?
Is the food or water supplemented with vitamins?
Has this pet been bred before?
Was the litter healthy?
Do you plan on breeding this pet in the future?
Is your pet here for a
Is your pet's activity level
Is your pet's appetite
Weight loss
Weight gain
Discharge from the eyes or nose
Increased breathing rate or effort
A change in the droppings
Increase in thirst
General weakness
Has your pet had any previous conditions, operations or problems (including dental or gastrointestinal problems)?
Is your pet currently on any medications?
Has your pet been on any medications in the past?
Is there anything else you would like done today?
Do you have any questions or need additional information?
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