Vets in Nottingham Ashfield House Veterinary Hospital

Name (Mr/ Mrs/ Ms/ Other )
Pet Details
E-mail
Name of Pet
Species
Age
Sex
Weight
Date acquired
Month Day Year
Source (e.g. Breeder/Pet Shop)
Hand reared or parent reared?

Hand reared Parent reared
If previously owned do you have any details e.g. how long, where, kept diet, any husbandry concerns?
Any previous illnesses?
If you pet has been treated at another vets previously, please give us the details in advance of your appointment so we can obtain clinical notes.
Does your bird live with other birds, if so are they the same species? How many?
Does your pets come into contact with any other pets, if so which ones?
Have any new pets been introduced, if so what and when?
You and your bird
Is your bird pair bonded to a human/ does your bird have a favourite human in the house?
Does your bird try to feed or regurgitate food on anyone in the house?
Does your bird behave aggressively to anyone in the house?
Are there any smokers in the house?

Yes No
Environment: If you bird's cages is too big to transport please bring as sample of cage lining so droppings can be inspected. A photograph of your bird’s cage will also be useful.
Size; length, height, width.
What is on the bottom of the cage?
How many food bowls are there?
How many water bowls are there?
How many perches are there?
What are they made of?
What toys does your bird have?
Does you bird have free flight outside of the cage?Where?
Does your bird play with anything outside of the cage? (e.g.childrens toys, furniture fixings, jewellery?
Does your pet go outside? When and for how long?
Do you have any supplementary heating or lighting?
Where is the cage in the house?
Are there TV's, radios, music players or computers in the same room?
What time at night do the lights get switched off in the room the bird sleeps in?
Do you use a cover over the cage?
Food
What do you feed your bird?
Anything else?
Which part of his/her diet does your bird enjoy best?
Where do you get the food from?
Any supplements?
Do you use cuttlefish or grit?
How do you provide water?
Does your pet get baths or sprays?
How often?
Do you use anything other than water?
When did your bird last moult?
Does your bird enjoy preening?
What is your concern regarding your pet's health?
If so for how long has this been going on? Are any other pets affected?
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Register your Bird online

Pet Details

If you pet has been treated at another vets previously, please give us the details in advance of your appointment so we can obtain clinical notes.

You and your bird

Environment: If you bird's cages is too big to transport please bring as sample of cage lining so droppings can be inspected. A photograph of your bird’s cage will also be useful.

Food

This form is designed to cover the requirements of a wide range of birds. Some questions may not be relevant to your pets, but for the Vet to make a full assessment, please answer as many questions as possible

If you prefer to print out the sheet and fill it in by hand, click here for form in pdf format

Contact Details