Mobile Veterinary Services for Birds and Fish

PO Box 1274
Taylors, SC, SC 29687

(864)483-9940

birddoctor.net

Please fill out this form before your appointment if you have ornamental aquarium or pond fish or you operate as an aquaculturalist (producer/fish farmer). Thank you for your cooperation. Having this information in our electronic medical record before the visit will be very helpful. If you have made an appointment please also fill out the New Client form

Please Note! Filling out the history form alone without also filling out the New Client form means no appointment can be scheduled nor do we have any contact information on the history form.


 

Alan M Fudge DVM, Dip ABVP-Avian Practice

*Owner Name First, Last
Names or IDs of fish
*Fish involved- common name(s)
*Length of time group has been together
*Reason for appointment request
Do you have a quarantine program for incoming fish?
*Previous diseases diagnosed and treated and how long ago?
*How long has tank/pond been operating?
How many gallons in the tank/pond
Type of lighting (natural, incandescent, fluorescent)
How many fish in the tank/pond?
Plants in the in tank/pond?
*Do you test the water? How often? What tests?
*Water changes- how often in days or weeks? What % of total gallons?
*Types of food fed and frequency
*Any recent fish introductions? How long ago?
*What are you observing with affected fish? How long? Any mortalities?
*Please list any medications or chemicals used in the last 90 days
Are you an aquaculturalist (fish farmer)
Aquaculturalist: your sales product- food fish, bait fish or ornamental fish?
Aquaculturalist: do you need assistance with regulatory interstate or international export?
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Mobile Veterinary Services

Birds & Fish
PO Box 1274
Taylors, SC 29687
(864)483-9940