rat/mouse history questions – existing patient

Please complete this form if your rat or mouse is an existing patient at The Wild Vet. If your rodent is a new patient, please complete the New Patient Form instead.

Owner First Name *

Owner Surname *

Owner Phone Number *

Rat/Mouse's Name *

Were any new pets introduced to the household recently? If so, were were they acquired from, and when? *

If their diet has changed recently, please describe. List all foods offered, including the amount. *

What treats do they receive? Include the amount and frequency of each. *

Is parasite prevention up to date? What was applied/administered, and when? *

Have their housing arrangements changed? Leave blank if not.

Describe the problem, including when it started? *

Have you noticed any diarrhoea? If so, describe the frequency, and when it was first noticed. *

Have you noticed any breathing changes or sneezing? 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 thirst or appetite? If so, please describe. *

Do you have any questions for the vet which haven't been mentioned in the above history questions?

Name

THE WILD VET

Rat/Mouse History Questions – Existing Patient

rat/mouse history questions – existing patient

THE WILD VET