Poultry/Waterfowl Husbandry Questionnaire

Sex

Male

Female

Sneezing/Nasal Discharge?

Yes

No

Head Shaking?

Yes

No

Vomiting/Regurgitation?

Yes

No

Diarrhea/Change in droppings?

Yes

No

Itchiness?:

Yes

No

Changes in Appetite?

Yes

No

Changes in activity/behavior?

Yes

No

Changes in group behavior?

Yes

No

Changes in laying/eggs?

Yes

No

Other birds affected?

Yes

No

Have you been to a vet before this?

Yes

No

Do they roam outside their coop?

Yes

No

Supervised/Unsupervised?

Supervised

Unsupervised

Do they come inside?

Yes

No

Do they eat pellets/crumble?

Yes

No

Do they eat scratch/seeds?

Yes

No

Do they eat other foods(vegetables/fruit/human foods)

Yes

No

Water source available

Bowl

Sipper