Questionnaire

New Patient (Exotics)

    • #Home#CellE-mailTextMail

    • MaleFemale

    • SpayedNeuteredunaltered

    • Species:

      Guinea PigRabbitOther

    • Other:

    • YesNo

    • Phone BookFriend/FamilyDriving By

    • ItchinessSoresLamenessChange in appetiteWeight gainWeight lossLethargyDiarrheaConstipation

    • Suddengradualn/a

    • NormalHyperactiveLethargic

    • NormalDecreasedIncreased

    • NormalDecreasedIncreased

    • NormalDecreasedIncreased

    • NormalWateryHard/Dry

    • YesNo

    • YesNo

    • IndoorsOutdoorsMy pet is exclusively kept indoors.

    • YesNo

    • YesNo