BIRD BEHAVIORAL QUESTIONNAIRE
Please review this entire questionnaire first, then go back and answer the questions as thoroughly as possible. Please return the questionnaire before the appointment if possible. Otherwise please have it with you at time of the appointment. If there was an incident (such as a bite), if possible, please ask those who were present for input as well.
Today’s Date *
Your Name *
Pet’s Name*
What is your pet's age? *
What is your pet's sex?*
Male
Female
Have you had pet's before you got this pet? *
Yes
No
Have you had a bird before?*
Yes
No
What is your pet’s breed?*
Why did you choose this specific breed/animal?*
Where did you get your pet?*
Stray/Found by me or someone in my household
Breeder
Animal Shelter
Pet Rescue
Advertizement (Not Breeder)
Pet Store
Given to me by a family member or friend
Baby of other pet(s)
How long have you had your pet? *
How old was he/she when you brought them home?*
When was your last Veternarian visit? *
List their medical conditions/allergies?*
Vaccinations have they had in the last 12 months?*
What brand/type of food does your pet eat?*
How many times a day is your pet fed? *
1
2
3-4
Free Feeding
How many days a week are you away from home?*
0
1-4
5-7
How often is your pet given treats?*
0
1-4
5+
How many hours are you away from home?*
0
1-5
6-9
10+
How do you prepare to leave home?*
Ignore them
I say goodbye to them
I Scratch and talk to my bird for awhile
What does your bird do as you prepare to leave?*
How many cages/enclosures do you have? *
How big is your bird’s cage?*
Much bigger than my bird
Just a bit bigger than my bird
An Aviary with lots of room
Where is the cage?*
In the kitchen
In the bathroom
In the bedroom
In the attic
In the entryway
In the pantry
In the basement
In the stairwell
In the laundry room
Outside
How many play gyms/stands do you have? *
Where is the main jungle gym/stand?*
In the kitchen
In the bathroom
In the bedroom
In the attic
In the entryway
In the pantry
In the basement
In the stairwell
In the laundry room
Outside
Where does your bird spend most of their time ?*
Inside in a cage/enclosure
Outside in a cage/enclosure
Indoors free-flighted supervised
Indoors free-flighted unsupervised
Outside free-flighted supervised
Outside free-flighted unsupervised
Indoors on a stand/play gym supervised
Indoors on a stand/play gym unsupervised
Outside on a stand/play gym supervised
Outside on a stand/play gym unsupervised
How often does your bird play outside cage?*
0 hrs
1-5 hrs
6-9 hrs
10+ hr
What kind of home do you live in?*
Apartment
Townhome
House
Farm/Ranch
List name, species, breed and age of other pets:*
List name, sex and age of people in household:*
What issue are you most concerned with? *
Aggression toward unfamiliar animal(s)
Aggression toward another pet in the home
Aggression toward family member(s)
Guarding cage/food/toys
Aggression toward visitors
Aggression when handled/picked up
Chewing inappropriate items
Not listening to commands
Biting
Separation Anxiety
Nuisance screaming
Approximate date/time this behavior started?*
Did a person move in/out of home when it started?*
Yes
No
Was a new person/baby in home when it started?*
Yes
No
Was a new pet in home when it started?*
Yes
No
Was there a change in owner’s work hours?*
Yes
No
Was there a change in routine?*
Yes
No
Recent vaccination/medication/surgery ?*
Yes
No
Did a pet/person in the home pass away?*
Yes
No
Was another pet lost/re-homed?*
Yes
No
What has been done to address the issue so far?*
Use of physical corrections
Sent away
Previous training
Have there been any environmental changes?*
Yes
No
Have you moved recently?*
Yes
No
Have you changed your pet’s diet recently?*
Yes
No
After the pet’s behavior was addressed:*
It improved
It worsened
It stayed the same
Please, list what commands your bird knows:*
Is there anything else you feel we should know?*