Exotic Mammal Patient Form

Fill out the fields below and we’ll get back to you.

Patient Name *

Breed

Patient Age

Sex

Spay/Neuter/Intact

Where Did You Get Your Pet (Pet Store, Breeder, Etc.) *

Reason for Todays Visit? *

Any Health Concerns? *

What type of enclosure does your pet live in? Approximate dimensions? *

What type of bedding do you use? *

Any furnishings, items that are in the enclosure all the time

How often do you clean the enclosure? *

Is your pet allowed outdoors? Supervised or unsupervised? *

How is water offered? Bowl or water bottle? How often is it changed? *

List all of the food you offer and how much? : *

Do you use any supplements? How often? : *

Do you bath your pet? Type of Shampoo? How Often? : *

Has your pet had any vaccines? : *

How does your pet exercise? (Free roam/play pen/wheel/toys) : *

Any other pets in the house hold? : *