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Brisbane Bird Vet

Dr Adrian Gallagher BVSc (Hons) MACVSc (Avian Health)

248 Hamilton Rd, Chermside QLD 4032
t 07 3359 2233

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Avian History Form

Please tell us about you and your bird.


    Environment


    NoYes


    NoYes


    PelletsSeedFruitsVegetablesTable FoodNutsOther:

    Medical History


    YesNo



    Chlamydia (Psittacosis)Psittacine Beak and Feather (PBFD)Neither of theseNot sure

    (e.g. New bird, boarding)
    YesNo

    YesNoNot sure

    YesNoNot sure

    YesNoNot sure


    YesNo


    Decreased AppetiteIncreased AppetiteAnorexiaWeight LossVomiting/RegurgitationDifficulty BreathingTail BobbingLethargyFluffed FeathersDiarrheaStool Caked to VentFeather PickingNasal or Eye DischargeEgg LayingNesting/BroodyMasturbationOther:


    Uploads

    If you have photos of your bird's cage or medical records, please upload them below or email them to us.


    Acceptable file types are JPG or PNG, up to 5mb in size.


    Acceptable file types are JPG or PNG, up to 5mb in size.


    Acceptable file types are PDF, DOC, DOCX, JPG or PNG, up to 8mb in size.

    Client Declaration

    All payments are due at the time of service. If your bird is to be hospitalised, a deposit will be required at the time of admission with the remainder due at discharge. We accept EFTPOS, Visa and MasterCard.

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