Avian Physical Examination Questionnaire Form InstagramThis field is for validation purposes and should be left unchanged.Owner’s NameDate MM slash DD slash YYYY AddressPostal CodePhone numbers (home)(cell)(work)Emerg. Contact(other than immediate family):ph:Pet’s NameBreedColourSex Male Female Unknown Age or Hatched DateSex confirmed by? DNA (feather/blood) Other (describe) Other (describe)Permanent Identification: Band:Microchip:What types of food are you feeding?Pellets – Brand(s)% of dietFresh fruit and veggies (types)% of dietGrains and nuts (types)% of dietOther table food% of dietSeeds – Brand(s)% of dietWhat does your bird actually eat?What is your bird’s feeding schedule?Does your bird have any foraging toys or opportunities to work for his/her meals?Describe:sleepingout of cageinteracting with family membersDoes your bird spend any time outdoors? YES NO How long/oftenDo you have any questions or concerns about your bird’s behaviorDoes your bird board or have contact with other birds? YES NO Describe:Do you have any other questions or concerns?