Javascript must be enabled for the correct page display
Hours & Contact
Open 24/7 - Including weekends and Holidays
(949) 785-2550
[email protected]
facebook
instagram
linkedin
google
yelp
Main Menu
Menu
Services
Critical Care
Emergency Surgery
Endoscopy
Exotic Emergency Vet
Laparoscopy
Pet Ambulance
Ultrasound
Urgent Care
About Us
Meet the Team
Careers
AAHA Accredited
Blog
Forms
Resources
Breeds
Dogs
Cats
Online Pharmacy
Primary Care
CALL NOW
Search
Avian
Behavior Form
Household Information
Please List All People Who Regularly Interact With Your Bird
Name
First
Last
Age
Relationship (child, spouse, housesitter, etc)
Email
Add another person
2nd Person
Name
First
Last
Age
Relationship (child, spouse, housesitter, etc)
Email
Add another person
3rd Person
Name
First
Last
Age
Relationship (child, spouse, housesitter, etc)
Email
List Other Pets/Birds In The Household
Name
Species / Breed
Current Age
Age When Acquired
Sex
Add additional pet
Pet 2
Name
Species / Breed
Current Age
Age When Acquired
Sex
Add additional pet
Pet 3
Name
Species / Breed
Current Age
Age When Acquired
Sex
Human/Bird Interaction
Provide a brief description of interactions between the bird and the people in the household (cuddling, playing, training, feeding, care)
How does your bird respond to his/her daily caregiver?
How does the bird react to familiar people?
How does the bird respond to unfamiliar people?
How does your bird react to new toys?
How does the bird respond in a new environment?
Does your pet allow petting? If yes, does your pet actively ask for it?
How does your pet respond to handling?
Problem Behavior
Details regarding your bird's problem behavior:
What is the behavior problem for which you are seeking advice?
Did a specific event prompt you to address this problem? If so, explain
When did you first notice the problem?
How often did it occur at the start? How often does it occur?
Do you feel there were any inciting factors? If so what?
What if anything have you done to treat the problem? Did it help?
Chronic Egg Laying
Yes
No
Chewing / biting / tearing skin
Yes
No
Damaging own feathers
Yes
No
Destructive chewing of furniture or other materials in environment
Yes
No
Screaming
Yes
No
Rubbing cloaca / vent on objects or people
Yes
No
Regurgitating
Yes
No
Repetitive Behaviors such as weaving / somersaulting
Yes
No
Lunging at/biting people or other animals
Yes
No
If you answered yes to any of these questions please describe more detail
Signature
Sign above
By checking this box, I authorize an electronic signature.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
