Date:
|
Client Name:
|
Patient Name:
|
Age:
|
Species:
|
Sex:
|
Address:
|
City:
|
E-Mail:
|
Fax:
|
Phone:
|
| Ownership History
|
Date Acquired:
|
From What Source:
|
Was Bird Parent Raised, Incubated, Hand Raised, Unknown?
|
Diet at time of Purchase?
|
Did your bird Fledge?
|
Did you purchase this species for a particular reason?
|
Did you purchase this sex for a particular reason?
|
| Health Check
|
Who is your Avian Vet?
|
When was most recent health check?
|
Describe any current Health problems:
|
Describe any previous health issues:
|
| Diet
|
Describe your birds diet and detail feeding routine- Include any vitamin supplements provided and treats given:
|
| Background Information:
|
What is the current Behavioural Issue?
|
When did current behavioural problem start?
|
Has there been any changes in your bird’s routine that may coincide with the behaviour change?
|
Describe any previous behaviour problems with your bird and the interventions undertaken-
|
Can you describe your bird’s personality?
|
Do you have other pets?
|
Have you previously owned other pets in the lifetime of your bird? Describe how the introduction process and how your bird interacted with each pet.
|
| Social Interaction:
|
Who spends the most time with the bird?
|
Who is the preferred person?
|
How are the bird keeping chores allocated?
|
Does your bird socialise with several family members? Describe-
|
Does your bird socialise with other birds/ animals? Has it ever?
|
Do you take your bird on outings?
|
What does your bird do when the preferred person leaves the room?
|
What does your bird do when the less preferred person leaves the room?
|
What does your bird do when the preferred person enters the room?
|
What does your bird do when the less preferred person enters the room?
|
Does your bird socialise with visitors?
|
| Activities:
|
Describe a day in the life of your bird?
|
Describe your bird’s cage
|
Does your bird play with toys? Describe preferred toy-
|
Does your bird like to chew and destroy items?
|
Does your bird visit multiple rooms of the house?
|
Does your bird fly?
|
Does your bird bath regularly? How?
|
Does your bird have access to newspaper?
|
Does your bird shred newspaper?
|
Does your bird allow you to remove feed bowls and other items from the cage?
|
How does your bird respond to activity around its cage?
|
Is your bird afraid of anything?
|
Does your bird return to security of cage by self?
|
Do you have difficulty returning your bird to the cage?
|
Is there a window where your bird can see outside?
|
Is your bird stick trained?
|
How do you get your bird out of its cage?
|
Does your bird step up on command?
|
Do you spend time with your bird for training?
|
Does your bird play with you?
|
Can you towel your bird? Describe-
|
Does your bird show signs of sexual arousal? Rub vent on cage, toys, humans etc
|
Does your bird regurgitate food?
|
|
|
Does your bird have nesting territories around the house?
|
Does your bird spend time outside? Describe-
|
| Sleep:
|
How many hours of sleep does your bird get?
|
Where does your bird sleep?
|
Do you cover your bird’s cage? Describe?
|
Is there a night light in your bird’s room?
|
Does your bird wake you in the morning?
|
| Feather picking:
|
Does your bird currently exhibit any unwanted behaviour besides feather picking? Eg Aggressive postures, claiming territory, nesting, biting, screaming- describe each
|
Does your bird attempt to feed you?
|
Where did the feather picking begin? Eg legs, neck, chest
|
Does your bird have bald spots? Where?
|
Are feathers pulled or chewed off?
|
At what stage of development are the feathers removed?
|
Are the wings clipped presently? Have they been clipped previously? Describe-
|
Does your bird only pick feathers at night?
|
Does your bird only pick feathers when humans are absent?
|
Does your bird pick feathers in front of humans
|
Is the feather picking intermittent? Daily? Rare but lots of feathers at a time? Did it progress slowly or rapidly? Can you think of any triggers for this behaviour?
|
Did the feather picking progress slowly or was there a sudden onset?
|
Can you think of any possible triggers?
|
What measures have been undertaken so far to reduce this behaviour?
|
| Screaming:
|
When does your bird scream? Is there a trigger for screaming behaviour?
|
Does your bird scream in the presence of humans?
|
Does your bird scream when other birds in the house vocalise?
|
Does your bird scream when out of the cage?
|
Does your bird scream when outside?
|
Does your bird scream when alone?
|
If multiple birds are owned- Does your bird share a cage?
|
If multiple birds are owned- How close is the nearest cage?
|
If multiple birds are owned- Can your bird hear parrots in another room?
|
Does your bird wake you with screaming behaviour?
|
How is the screaming being managed?
|
What interventions have been undertaken to reduce screaming?
|
What is the human reaction to screaming?
|