Avian lifestyle Assessment Please click the button below to fill out the form. Get Started 7 Avian Lifestyle Assessment Please fill out the form as completely and as accurately as possible, thank you. Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Pet's Name *Origin:Wild Caught or Hand Raised?SpeciesWho/where did you obtain the bird from? SexAgeLength of OwnershipReason we are seeing your pet today *Duration of complaint *Is it getting worse, improving or staying the same? *Previous or current medications/vitamins & minerals *Any prior health issues we should know about? *Please list previous vaccinations and diagnostics work as well as when they were given *List seed brand/type, amount and frequency fed if providedList pellet brand/type, amount and frequency fed if providedList cooked foods brand/type, amount and frequency fed if provided Example: Bird Street BistroList fruit brand/type, amount and frequency fed if providedExample: Bird Street BistroList veggies brand/type, amount and frequency fed if providedExample: Bird Street BistroList table food brand/type, amount and frequency fed if provided Example: Bird Street BistroList treats brand/type, amount and frequency fed if provided)Example: Bird Street BistroList supplements brand/type, amount and frequency fed if provided) (copy)Example: Bird Street BistroChanges in appetite?Yes- increasedYes- decreasedNoPlease list any recent diet changes and when they occured:Any regurgitation?YesNoDo droppings appear normal in color and amount produced?YesNoAttitude/Personality normal?YesNoVoice quality normal?YesNoCage Type ChromeGalvanizedPaintedWoodSolderedFloor type, substrate on floor and toys inside cagePlease list any other birds and their species:Which of these do you use?Nonstick pansPaintsAdhesivesPesticide sprayHousehold cleanersWood burning stoveCandles or incenseDoes anyone in your household smoke?YesNoPlease list any unusual or odd behavior:Last time services were doneExample: Nail trim, Wing trim or Beak trimWhat services would you like to get done today, if any?Submit
