AVIAN HISTORY
Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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5
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31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
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2003
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2001
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1999
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1994
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1991
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1981
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1939
1938
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1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Pet Name
*
Breed
*
Purchased/ adopted from (include state)
*
Approx Date Of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Band #?
*
Open or Closed?
*
Open
Closed
Sex
*
Please Select
Male
Female
N/A
Known by bloodtest?
*
Yes
No
In with cage mate?
*
Yes
No
Band #?
*
Any egg laying?
*
Yes
No
How often?
*
How many?
*
Other bird types in house/ environment (store):
Number
*
Breeds
Environment:
Shape of cage
*
Round
Rectangle
Other
Approx. dimensions: (ex. 3ft X 3ft)
*
Number of Perches
*
Types of Perches:
*
Natural wood
Wood rod
Plastic/Metal
Rope
Toys:
Mirror
Metal
Wooden
Beds
Other
Room cage is located?
*
Distance from nearest window?
*
Approximate temperature of area
*
Time spent outside
*
Use candles/air fresheners in house?
*
Yes
No
Brand
Smoking in house?
*
Yes
No
Diet:
Seed?
*
Yes
No
Brand
*
Pellets?
*
Yes
No
Brand
*
Does pet eat all the food?
*
Yes
No
Is food changed often?
*
Yes
No
Grit?
Yes
No
Vitamins?
*
Yes
No
Brand
Medicine?
*
Yes
No
Type
Table food?
*
Yes
No
Please list:
Of the food choices mentioned above, what does he or she eat?
*
Do you mist?
*
Yes
No
How often?
Do you shower/soak?
*
Yes
No
How often?
What do you use to clean the cage?
Previous illnesses? Please list:
Prior test results/ Vet?
Exposure:
Has pet been exposed to any chemicals/ toxins?
*
Yes
No
Any trauma/ injury?
*
Yes
No
Other people/animals/birds who were ill?
*
Yes
No
Describe all:
Abnormal signs:
Appetite normal?
*
Yes
No
Droppings normal?
*
Yes
No
Activity normal?
*
Yes
No
Feathers normal?
*
Yes
No
Other:
Yes
No
Please list what, how long, progression:
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