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Avian Name or Identification: *
Common or scientific species name: *
From where did you obtain this bird?:
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When did your bird last molt?:
How often has your bird been molting?:
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When was the last bird added to your collection?
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What is the primary complaint or what signs have you noticed?:
How long have these problems been present?:
What problems has your bird had previously?
Please give details (what was used, dosage, how often, duration): *
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often?: How the
How often do you feed your animal? *
Which foods are eaten? Seed mixtures, fruits, vegetables, meat, insects, treats, other? Please be specific with brand, type, and in what amounts (by number, weight, or approx. volume). If meat, please indicate if freshly killed, frozen/thawed, or live prey* *
Please indicate what, how much, and how often: *
How is the water provided (bowl, dripper system, tray) and how often?: *
How often is the water changed? *
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Where is the cage located? Inside or outside? Please give details *
What is the cage made of? *
Cage size? *
What kind of bedding is used? *
What decor and furnishings are present (nest box, perches, swings, toys, other)? Please give details *
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How often is the cage cleaned? What cleaning/disinfectant agents are used? *
What percentage of time does your bird spend inside and outside of it's cage? *
Is the bird supervised when out of the cage? Please give details: *
Frequency and length of time?: *
Brand?: *
What is your bird's light/dark cycle?:
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