Online Forms

Small Mammal History Form

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Small Mammal History Form

Animal Details

Name *

Origin *

Captive Breed
Wild Caught Import
Unknown

Date of Birth *

Age *

Sex *

Male
Female
Neutered/Spayed
Unknown

List Vaccines and Dates Given

Species *

Where did you obtain this animal? *

Do you own other pets? If so, how many/what kind? *

Have you or your pet had contact with other animals in the last 30 days? Explain. *

Reason for Presentation Today

What signs/symptoms have you noticed? For how long? *

Has your pet received any treatment in the last 30 days? If yes, please give details (medication, dosage, frequency, duration): *

Cage Environment

Where is the cage?

Indoor
Outdoor

Dimensions of Cage *

Is your animal supervised when out of the cage?

What percentage of time does your animal spend in the cage? *

What is the cage made out of?

Plastic/Fiberglass
Wood
Metal
Glass
Other

How often is the cage cleaned?

What cleaning/disinfecting agents are used?

What decor and furnishings are present?

Please describe any changes to your pet's environment in the last 3 months:

Are there additional ventilations (grills or mesh)? If so, give details:

What bedding do you use?

Is your animal litter trained?

Please describe your animal’s bathing facilities:

What is your animal’s day and night cycle?

Does anyone in the household smoke?

Do you use aerosolized products?

Diet

How often do you feed your animal? *

Vegetables, Type and amount per feeding: *

Fruits, Type and amount per feeding: *

Pellets, Type and amount per feeding: *

Hay, Type and amount per feeding: *

Treats, Type and amount per feeding: *

Meat, Type and amount per feeding: *

If you use any nutritional supplements, please list them here: *

What water supply do you provide? *

Tap Water
Bottled Water
Rain/River Water

How is that water provided? *

Bowl
Dripper System
Spray

How often is the water changed?

Website

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Book an Appointment in Rowlett, TX

At Four Paws Animal Hospital, we treat your pets like the valued family members they are. We proudly serve the pets of Rockwall, Garland, Sachse, Wylie, and beyond. We look forward to seeing you and your pet!

Easily book an appointment for your pet using our online system.

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Address

5620 Rowlett Rd.
Rowlett, TX, 75089

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Hours

Mon-Fri: 7:30 am-5:30 pm (Closed from 12 pm-1:30 pm for staff development)
Sat-Sun: Closed

Contact

P: 972-475-7696
F: 972-475-6465
E: fpah@fourpawsinfo.com

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