Guinea Pig Questionnaire

Client Details

Name

First Last

Phone Number

Email Address

Guinea Pig Details

Name

Age (date of birth)

Sex

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