Avian Pre-Visit Questionnaire Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet’s before your visit.

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Avian Pre-Visit Questionnaire Form

As Fear Free Certified Professionals, we want to make your bird’s veterinary experience as enjoyable and as stress-free as possible. As such, it’s important for us to understand what your bird might find upsetting. This information will help us to adjust our care to better serve and comfort your bird. Please answer the following questions to the best of your ability so we can take into consideration both you and your bird’s preferences.

Your Name *

First

Last

Bird's Name *

Does your bird show any reluctance to getting in the carrier?

During travel to the veterinary hospital, does your bird do any of the following:

Eyes wide open
Increased respiration
Defecating
Feathers slicked tight
Vocalizing
Crouching/quivering wings
Freezing in place
Chewing toes
Trying to fly away/escape
Darting looks
Eye pinning
Feather loss
Other

Does your bird prefer:

Female Veterinarian
Male Veterinarian
It Doesn't Matter

Check any situations listed below that your bird has shown avoidance or dislike of in the past. You can add additional comments at the end.

Getting in their carrier or the car
Entering the veterinary hospital
Other pets and/or people passing by while in reception
Waiting with other people and animals in the waiting area
Being approached by veterinary staff
Getting on the scale for a weight
Hearing the doorbell, overhead intercom, or phones ringing
Being taken out of the exam room for procedures
Going into the exam room
Being examined
Having direct eye contact with the technician and/or veterinarian
The use of instruments such as the stethoscope
Being taken out of the carrier
Loud voices during the examination
Sounds coming from the back areas of the practice

How would you describe your bird around other animals and people?

Does your bird have any sensitive areas that they do not like to have touched by you or others?

Are there any procedures your bird has not liked having performed at the veterinary hospital in the past or that seemed difficult for you or the staff to do? (weight, temperature, exam, blood draw) If so, how did your bird react?

What are your birds favorite treats? (Please bring some to your next visit to our hospital)

Does your bird like to play with toys? If so, what kinds?

Has your bird ever been prescribed any supplements or medications to help with a visit to the veterinary hospital? If so, what was it and what sort of results did you experience?

Anything else you would like us to know?