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Home
About Us
Location & Hours
Team
Associated Veterinary Specialists
Continuing Education
Community Involvement
Our Patients
Success Stories
Send Us Your Photos
Services
Medical Services
Surgery Services
Specialty Services
Wellness and Preventative
Laser Procedures
Blood and Plasma Transfusions
Nutrition
Anesthetic Monitoring
Resources
Educational Articles
Educational Presentations
Pet Health Checker
Forms
Make an Appointment
Exotic Appointment Form
Prescription & Food Refill
Referral Forms
Emergency
Emergency Procedures
Emergency Procedures – Dogs and Cats
Emergency Procedure For Your Pet Bird
Emergency Procedures For Your Reptile
Emergency Procedures – Small Mammals
Wildlife Emergency Procedures
Links
Blog
Guinea Pig Questionnaire
Client Details
Name
First
Last
Phone Number
Email Address
Guinea Pig Details
Name
Age (date of birth)
Sex
Male
Female
Is your guinea pig spayed or neutered?
Date acquired
Source (pet shop, friend, breeder, etc)
Details of Other Pets
Do you have any other guinea pigs? 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
What is the temperature in your home?
Is the house centrally heated?
Are the windows in your home double-insulated?
Is your guinea pig kept in a cage indoors? If yes, please provide approximate dimensions
Please describe the bedding and litter used in the cage
Are there any smokers in the household?
Where does your guinea pig urinate and defecate?
Has your guinea pig damaged any household items? If yes, please provide details (item, how and when it was damaged)
Food
Please describe your guinea pig’s diet (Include pellets, any table food, treats etc.)
Where do you purchase your guinea pig's food?
Has there been a recent change in diet? If yes, please specify
Are any of the following given to your guinea pig?
Vitamins
Minerals
Medicines
Probiotics
Tonics
Water
Does your guinea pig drink from a bowl or a sipper-bottle?
How much water does your guinea pig drink each day?
Has the drinking increased or decreased as of late? If yes, when did you notice?
The Presenting Health Concern
Has your guinea pig had any previous health issues? If yes, please provide details
Please describe your guinea pig’s clinical symptoms
Does the skin and fur appear normal?
Has there been any excessive scratching?
Has there been any nasal or ocular discharge? If yes, please provide details
Has there been any odd positioning or loss of use of any limbs? If yes, please specify
Has there been any abnormal vocalization?
Are your guinea pig’s droppings normal in appearance and size? If not, please provide details
Any additional comments