Small Mammal History Form Client Name* First Last Pet's Name*Species*Age**PetBreederBackground InformationLength of time owned*Where acquired?*BreederPet StoreHow often is pet handled?*DailyOccasionallyNeverCharacter of feces*HubandryHoused Indoors/Outdoors?*Where is cage located?*s pet allowed to roam free in the house?*YesNoType of Caging*Size of Caging*Galvanized?*NoYesUnsureCage Substrate?*How often is cage cleaned?*What type of disinfectant is used when cleaning cage?*Types of toys/furniture offered?*Litter Box Offered?*NutritionTypes Of Food OfferedPellets?*YesNoIf yes, what brand? Amount fed/frequencySeed?*YesNoIf yes, what brand? Amount fed/frequencyFruits / Veggies?*YesNoIf yes, what brand? Amount fed/frequencyHay?*YesNoIf yes, what brand? Amount fed/frequencyOtherTypes of Supplements/Treats offered:*Water Source*How Often Is Water Changed?*Any Other Pets?*YesNoIf Yes, SpecifyDo Other Pets Interact With This Pet?*YesNoIf Yes, SpecifyAre Pets housed Together Or Singularly*If not housed together, where are other pets located?*Any new additions to the pet population?*YesNoIf Yes, SpecifyWere the new additions properly quarantined separate from rest of pet population before introduced?*Past Medical History/Problems:*Current Presenting Problems:*Duration of Problem:*PhoneThis field is for validation purposes and should be left unchanged.