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Same Day Urgent Care

Phone: (207) 208-8508 | Monday - Thursday: 8AM - 6PM | Friday: 12PM - 6PM | Saturday: 8AM - 2PM | Urgent Care Offered Daily

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(207) 208-8508 Hours Book an Appointment

New Patient Form – Avian

Name (Person filling out form)(Required)

First Last

Date(Required)

Month

Day

Year

Pet's Name(Required)

Breed(Required)

Sex(Required)

Age(Required)

Owner / Caregiver name(Required)

First Last

Background

Length of time owned(Required)

Place of purchase(Required)

Rescue

Pet Shop

Breeder

Other

Housing

Housed indoors or outdoors?(Required)

Indoors

Outdoors

Both Indoors and Outdoors

Where is the cage located?(Required)

Type and size of cage?(Required)

What toys are available?(Required)

Is the animal allowed free roaming in the house?(Required)

Social Environment

Any other pets?(Required)

Yes

No

Please specify other pets(Required)

Are animals housed together or separate?(Required)

Together

Separate

If not housed together, what interactions do the animals have?(Required)

How often is your pet handled?(Required)

Daily

Occasionally

Never

Other

Water

What water source is offered?(Required)

Bowl

Water Bottle

Other

How often is the water changed?(Required)

Are there opportunities for bathing?(Required)

Bowl

Mister

Shower

Other

Food

What types of food does your pet eat? (select all that apply)

Pellets

Produce

Seeds

Treats

Pellets - Brand / Type(Required)

Pellets - How much and how often?(Required)

Produce - Brand / Type(Required)

Produce - How much and how often?(Required)

Seeds - Brand / Type(Required)

Seeds - How much and how often?(Required)

Treats - Brand / Type(Required)

Treats - How much and how often?(Required)

Describe any other food items or supplements

Δ

CONTACT INFO

4 Post Road
Freeport, ME 04032

Phone: (207) 208-8508
Email: freeport@carevethealth.com

HOSPITAL HOURS

Monday - Thursday: 8:00 AM - 6:00 PM

Friday: 12:00 PM - 6:00 PM

Saturday: 8:00 AM - 2:00 PM

Sunday: Closed

Urgent Care Offered Daily

Patients seen by appointment.

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