Ferret History Form

Pet's Name *

This pet *

has been seen before is a new patient

Date of Birth *

Gender *

Male Female Male Neutered Female Spayed

Do you have previous medical records? *

Yes No

If you do have previous records, please have them forwarded to us

Color *

How Long have you owned your ferret? *

Enviroment

What type of cage does your ferret have? *

Type of bedding used *

How often is the cage cleaned? *

Does your ferret use a litter box. If so what type of litter *

Does your pet spend time out of the cage? *

Yes No

How Much time, where? *

Cage Dimensions *

Where is the cage located? *

Briefly describe the cage accessories (bowls, toys...) *

Are any other ferrets in the cage? Number? *

Diet

Medical History

Has your ferret ever been vaccinated? *

Rabies Distemper Adverse Reaction No adverse reaction

Thank you for taking the time to fill out this form. Having this information will allow you to get more out of your time with the doctor.

Office Hours

Monday 8am to 5pm
Tuesday 8am to 5pm
Wednesday 8am to 5pm
Thursday 8am to 5pm
Friday 8am to 5pm
Saturday 8am to 1pm

In event of an emergency
please call 856-751-2122 for information on contacting the on call doctor.