Guinea Pig Health Questionnaire Owner’s Name Date Address Postal Code Phone numbers (home) (cell) (work) Email Emerg. Contact(other than immediate family): Pet’s Name Breed Colour Sex Male Female Neutered Spayed Age or Birthday How 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/day Alfalfa pell ets cup/day Fruits & Vegetables cup/day Other Does 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? Yes No What 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? Yes No If yes Has your guinea pig been to a veterinarian before? Yes No If 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? Yes No If 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? Untitled PhoneThis field is for validation purposes and should be left unchanged.
