Guinea Pig Health Questionnaire Owner’s NameDateAddressPostal CodePhone numbers (home)(cell)(work)Email Emerg. Contact(other than immediate family):Pet’s NameBreedColourSexMaleFemaleNeuteredSpayedAge or BirthdayHow did you acquire your guinea pig?What type of food do you feed and how much do you feed ?Timothy hay% of dietAlfalfa hay% of dietTimothy pellet cup/dayAlfalfa pell ets cup/dayFruits & Vegetables cup/dayOtherDoes you guinea pig drink from a bottle or bowl?Does your guinea pig receive a daily vitamin C supplement?If yes, how is it given (i.e. chewable tablets added to water, etc):Does your guinea pig use a litter box?YesNoWhat do you use for litter?How often do you clean your guinea pigs cage?What do you use for bedding?How much time does your guinea pig spend in its cage?Do you groom your guinea pig? (i.e. trim nails, brush fur)? How often?Does your guinea pig have any contact with other pets/animals inside or outside of your home?YesNoHas your guinea pig been to a veterinarian before?YesNoIf yes, when/where?Does your guinea pig chew on things that he/she should not chew on?Has your guinea pig ever had his/her teeth trimmed?YesNoIf yes, when/where?Has your guinea pig had any wet, clumped fecal matter? How often do you notice it?Have you noticed any of the following; Scratching Flakey skin Teeth grinding Lumps or bumps Runny eyes/nose Changes in urine or fecal production Sneezing and/or coughing Changes in behavior Changes in eating and/or drinking habits Size in fecal balls Do you have any other questions or concerns?NameThis field is for validation purposes and should be left unchanged.