Small Rodent Husbandry Questionnaire

Sex

Male

Female

Unknown

Reproductive Status (Select One)

Intact

Spayed

Neutered

Coughing?

Yes

No

Sneezing?

Yes

No

Nasal Discharge?

Yes

No

Oral Discharge?

Yes

No

Diarrhea/Change in Feces?

Yes

No

Changes in Thirst?

Yes

No

Changes in Urination?

Yes

No

Bulging Eyes?

Yes

No

Changes in Walking/Movement?

Yes

No

Changes in Appetite?

Yes

No

Changes in Activity?

Yes

No

Itchiness?

Yes

No

Have you been to a vet before this?

Yes

No

Fed pellets?

Yes

No

Fed a salad?

Yes

No

Water source available

Bowl

Bottle