Please answer all questions as best as possible:

What is the duration of the observed problem?

Are there other pets?

What exposure does the animal have to other animals?

Are other pets ill? ( Birds : Have there been any sick or dead birds in the house recently?)

Has the pet had other medical problems? ( Birds: Has the bird ever been sick before?)

Has the pet received any medication?

When was the pet first introduced to the home?

Where was the pet obtained? (Be specific: breeder/pet shop/bird fair—swap meet)

Did the pet come with a guarantee?

Where is the pet kept in the home?

What substrate (bedding) is used in the enclosure?

Is the home heater, electric, or gas?

What temperature is the home?

What houseplants does the pet have access to?

Is the pet frequently exposed to fresh air and sunlight? (Please give details)

Is the photoperiod natural and regulated or random and irregular? (Is the natural

environment's day time/nighttime imitated at home?)

Are exterminators used?

Is the pet exposed to cigarette smoke?

What potential aerosols is the pet exposed to?

What disinfectants are used in the enclosure and how often?

Have any changes recently occurred in the home?

What types of foods are offered? ( Birds: Also-Where do you buy the food?)

What types of foods are consumed? ( Birds: What % of food is consumed?)

What feeding schedule is used?

Is the appetite increased or decreased? (If yes, please specify duration)

How often are the food & water dishes cleaned, & what is used to clean them?

Have the feces (droppings) changed in color, frequency, consistency, or quantity?

Has the water intake changed?

Any: coughing, sneezing, diarrhea, or vomiting?

Have noted changes remained the same or progressed?

Is the bird allowed out of the cage?