Name: Campus Estates Animal Hospital
Address: 1460 Gordon Street, Guelph, ON, N1L 1C8, CA
Telephone: 519-837-1212
Price range: $$

Gerbil History Form

Client Details
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number
Alternative Phone Number
Email Address
Gerbil Details
Name
Age (date of birth)
Sex
Is your gerbil spayed or neutered?
Date acquired
Source (pet shop, friend, breeder, etc)
Details of Other Pets
Do you have any other gerbils? If yes, please provide details (name, date acquired, source, any known illness)
Do you have any other pets? If yes, please provide details (species, date acquired, source, any known illness)
Husbandry
Is your gerbil kept in a cage indoors? If yes, please provide approximate dimensions
Please describe the bedding and litter used in the cage
Where does your gerbil urinate and defecate?
Has your gerbil damaged any household items? If yes, please provide details (item, how and when it was damaged)
Food
Please describe your gerbil’s diet (Include all store purchased food and any items that you supplement with)
Has there been a recent change in diet? If yes, please specify
Are any of the following given to your gerbil?
- Vitamins
- Minerals
- Medicines
- Probiotics
- Tonics
Water
Does your gerbil drink from a bowl or a sipper-bottle?
Have there been any changes in drinking habits for your gerbil?
Has the drinking increased or decreased as of late? If yes, when did you notice?
The Presenting Health Concern
Has your gerbil had any previous health issues? If yes, please provide details
Please describe your gerbil’s clinical symptoms
Does the skin and fur appear normal?
Has there been any excessive scratching?
Has there been any odd positioning or loss of use of any limbs? If yes, please specify
Has there been any abnormal vocalization?
Do you notice coprophagy (gerbil eats droppings)?
Are your gerbil’s droppings normal in appearance and size? If not, please provide details
Any additional comments

For appointments please call 519-837-1212 Make an Appointment

Gerbil History Form

Client Details

Gerbil Details

Details of Other Pets

Husbandry

Food

Water

The Presenting Health Concern

About Us

Regular Clinic Hours

Location

Directions