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Veterinarians in Lebanon, New Hampshire | Stonecliff Animal Clinic
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Small Exotic Mammal Initial Visit
Home
» Small Exotic Mammal Initial Visit
Small Exotic Mammal Initial/Annual Visit
First time visit or yearly wellness check up
Name
First
Last
Date
Date Format: MM slash DD slash YYYY
Pet's Name
Gender
Male
Female
Age
Approx. age when obtained
Previous Vet
Current Medications
Reason for Visit
Diet (fed vs eaten)
Amount Offered
Amount Eaten
Fresh Fruits (list all)
Amount Offered
Amount Eaten
Fresh Vegetables (list all)
Amount Offered
Amount Eaten
Insects
Amount Offered
Amount Eaten
Meats (list all types)
Amount Offered
Amount Eaten
Mixes/Home Cooked Meals (list all ingredients
Amount Offered
Amount Eaten
Treats (list all)
Amount Offered
Amount Eaten
Source of Drinking Water
Bottled or Dish
Bottled
Dish
Vitamin and Mineral Supplements
No
Yes
Type
In Water or Food
Water
Food
Frequency Food is Changed
Frequency Water is Changed
Housing: Enclosure or Terrarium
Terrarium
Enclosure
What is Enclosure Made out of?
Type of Bedding
Frequency Bedding Changed
Disinfectant Used to Clean Enclosure
How often
Is pet housed alone?
yes
no
If no how many other pets are housed with this pet?
Type of animals housed with pet?
Are there other pets in the household?
yes
no
If yes please list them:
Are any ill?
yes
no
If yes please describe
How often is your pet handled?
House is your pet exercised?
Frequency of exercise?
Does your pet go outside?
never
50%
always
Please bring this form with you when you come in for a visit
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Services
Pet Health Library
Location Hours
Monday
8:00am – 7:00pm
Tuesday
8:00am – 7:00pm
Wednesday
8:00am – 7:00pm
Thursday
8:00am – 5:00pm
Friday
8:00am – 5:00pm
Saturday
8:00am – 5:00pm
Sunday
Closed
New Winter Hours: Closed Sunday
