$25 OFF Your New Pet’s First Visit*
*Valid for a pet’s first visit to our hospital only. Available to both new and existing clients bringing a pet that has never been seen at our practice. Must be mentioned at checkout to redeem. No cash value.

Online Form

Avian History Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet’s before your visit.

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Avian History Form

Name *

First

Last

Email *

Pet's Name

This bird

Is a new patient
Has been seen before

Species *

Age (Best Guess) or Date of Birth *

How long have you owned your bird? *

How often is your bird handled?

Every Day
Ocassionally
Never

Where was your bird acquired?

Pet Store
Breeder
Other

Gender

Male
Female
Unknown

Does your bird go outside

Often
Sometimes
Never

Environment

What type of Cage does your bird have?

What are the dimensions of the cage

Where in the house is the cage located?

Do other birds share the cage? How Many?

How often is the cage cleaned?

Briefly describe the cage (perches, water bowls, bedding...

What kind of food do you feed your bird?

Pellets
Seed
Fruits
Vegetables
Table Food

Please specify Brands and types of foods along with percentage of diet.

Medical History

Do you have previous medical records?

If you do have previous records, please have them forwarded to us

Please list any previous medical problems

Has your bird ever been tested for:

Chlamydophila (Psitticosis)
Polyomavirus
Psittacine Beak and Feather
Avian Bornavirus

If so, Where?

Has your bird recently been exposed to other birds? (New bird? Boarding?)

Is your Bird groomed regularly?

Wings
Beak
Nails
None

If so, by whom?

Do you bathe your bird?

Spray Bottle
Bath/Shower
No

If you do bathe your bird, how often?

Does your bird have a full spectrum (UVB) bulb

Have ther been any changes in your birds environment?

Are you concerned with any behavior problems?

Have there been any changes in your birds' droppings? Please describe

Are there any smokers in the house?

Have you noticed any of the following?

Decreased Appetite
Increased Appetite
Anorexia
Weight Loss
Vomiting/Regurgitation
Difficulty Breathing
Tail Bobbing
Lethargy
Fluffed Feathers
Diarrhea
Stool Caked to vent
Feather Picking
Nasal or Eye Discharge

Thank you for taking the time to fill out this form. Having this information will allow you to get more out of your time with the doctor.

Schedule An Appointment

We proudly serve the pets of Cherry Hill, NJ and surrounding communities. We look forward to seeing you and your pets!
Book an appointment by clicking the button below.

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Questions?

Get in touch! We look forward to hearing from you.

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Location

1785 Springdale Road
Cherry Hill, NJ 08003

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Contact Information

Phone: 856-281-7607
Email: info@animalandbirdvet.com

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Hours

*Appointments do not start until 9am
Monday-Friday: 8 AM – 5 PM
Saturday: 8 AM – 1 PM
Sunday: Closed

Name *

First

Last

Email *

Phone

How can we help you? *

Phone

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Service Area

We serve the cats, dogs, exotics, and birds of the following areas: Cherry Hill, Voorhees, Marlton, Mt. Laurel, Medford, Haddonfield, Haddon Heights, Haddon Twp, Audubon, and Collingswood.