Ferret Health Questionnaire Form Owner’s Name Date Address Postal Code Phone numbers (home) (cell) (work) Email Emerg. Contact(other than immediate family): ph: Pet’s Name Breed Colour Sex Male Female Neutered Spayed Age or Birthday How did you acquire your ferret ? What type of food do you feed your ferret and h ow much do you feed? Treats Other Has your ferret been to a veterinarian before? If yes, when/where? Yes No If yes Has your ferret received vaccines before? If yes, when/which vaccines? Yes No If yes Does your ferret drink from a bottle or a bowl? Does your ferret use a litter box ? Yes No If yes How much time does your ferret spend in its cage or does he/she have their own room to run in? What kind of toys or stimulation do you offer to your ferret? What do you use for bedding and how often do you clean the cage ? Does your ferret go outside? If yes, how much time is spent outside? Yes No If yes Do you groom your ferret (i.e. trim nails, brush fur)? Yes No If yes, how often? Do you provide dental care for your ferret ( i.e. brush teeth)? Yes No If yes, how often? Does your ferret have any contact with other pets inside or outside of the home ? Yes No If yes Are there any health issues you wish to discuss? Yes No If yes Does your ferret chew on things that he/she should not chew on? Yes No Have you noticed any of the following: Coughing or Labored Breathing Limping Lethargy Lumps or bumps Sneezing Increased Thirst Increased Urination Vomiting Diarrhea Constipation Scratching Flakey skin Hair loss Changes in eating habits Discharge from eyes/nose Changes in urine or stool Changes in behavior Do you have any other questions or concerns ? NameThis field is for validation purposes and should be left unchanged.
