Mobile Veterinary Services for Birds and Fish

PO Box 1274
Taylors, SC, SC 29687


Please fill out this form before your appointment if you have ornamental aquarium or pond fish or you operate as an aquaculturalist (producer/fish farmer). Thank you for your cooperation. Having this information in our electronic medical record before the visit will be very helpful. If you have made an appointment please also fill out the New Client form

Please Note! Filling out the history form alone without also filling out the New Client form means no appointment can be scheduled nor do we have any contact information on the history form.


Alan M Fudge DVM, Dip ABVP-Avian Practice

spacer*Owner Name First, Last
spacerNames or IDs of fish
spacer*Fish involved- common name(s)
spacer*Length of time group has been together
spacer*Reason for appointment request
spacerDo you have a quarantine program for incoming fish?
spacer*Previous diseases diagnosed and treated and how long ago?
spacer*How long has tank/pond been operating?
spacerHow many gallons in the tank/pond
spacerType of lighting (natural, incandescent, fluorescent)
spacerHow many fish in the tank/pond?
spacerPlants in the in tank/pond?
spacer*Do you test the water? How often? What tests?
spacer*Water changes- how often in days or weeks? What % of total gallons?
spacer*Types of food fed and frequency
spacer*Any recent fish introductions? How long ago?
spacer*What are you observing with affected fish? How long? Any mortalities?
spacer*Please list any medications or chemicals used in the last 90 days
spacerAre you an aquaculturalist (fish farmer)
spacerAquaculturalist: your sales product- food fish, bait fish or ornamental fish?
spacerAquaculturalist: do you need assistance with regulatory interstate or international export?
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Mobile Veterinary Services

Birds & Fish
PO Box 1274
Taylors, SC 29687
(does not receive text messages)

New Client Form New Client Form QR Code

Avian History Form Avian History Form QR Code 

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