Owner First Name *
Owner Surname *
Owner Phone Number *
Fish's Name *
Describe their diet: list all foods offered, including the amount, and frequency of feeding each item. *
What is the water temperature? *
How often is the water changed, and what percentage? *
How often is the water tested? What were the most recent results? *
Describe the water filtration system used? *
When did they last eat? *
Describe the problem, including when it started? *
Are any other fish in the tank affected? *
Has there been a recent change in environment? *
Have you noticed any respiratory signs (gulping air at the surface, increased gill movements, buoyancy issues)? If so, describe the frequency, and when it was first noticed. *
Has there been a recent change in behaviour? If so, please describe. *
Has there been a recent change in appetite? If so, please describe. *
Have any medications or water additives been added to the tank? If so, list what was used, and when: *
Do you have any questions for the vet which haven't been mentioned in the above history questions?
