Freshwater Aquatic Pet Husbandry Questionnaire Form

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Please complete our Freshwater Aquatic Pet History Form before your visit.

If you don't know the answer to a question on this form simply write "unknown" as your answer.

Owner's Name *

First

Last

Phone Number

Email *

Pet's Name (if applicable)

What Species Are You Bringing For An Exam? *

Sex *

Female
Male
Unknown

Has your pet been seen at another veterinary clinic? *

Yes
No

Main Concern/Problem for this pet *

Have you tried any at home treatments/remedies or medications on your pet already to address the problem they have? If so what and for how long? *

Any difference noted with what you did? *

Are there other affected individuals in your collection showing the same signs/symptoms or have different abnormal symptoms as the pet you're bringing today (please describe and include species affected if different then your pet coming for an exam)? *

How long have you owned this aquatic pet? *

Size when purchased (approximate)? *

Current length (approximate)? *

What other fish, invertebrates, plants etc are housed in the same display tank with the aquatic pet you brought today?

What do you feed your pet? *

How often do you feed your pet? *

Is your pet currently eating? *

When is the last time they ate and what did they eat or show interest in? *

Aquarium Size (gallons) *

How many gallons of water do you replace at each water change? *

How often do you do routine water changes? *

How often do you check your tanks water parameters (pH, salinity, kH, Nitrate, Nitrite, Ammonia)? *

What water source do you use for your water changes (ex. Tap water, well water, RO water, etc)? *

Do you treat your water with a product to remove chlorine/chloramine prior to adding it to your aquarium? *

After treating your water how long do you wait to use it in your tank? *

What are your aquarium parameters?

Salinity *

pH *

kH *

Nitrite *

Nitrate *

Ammonia *

Tank Temperature *

Do you add chemicals or aquarium products (ex. Buffer) to the tank routinely? *

Yes
No

How often (if applicable) are these additives monitored with a test kit to determine levels before/after adding? *

Tank substrate?

Live Plants?

Do you have a quarantine tank? *

Yes
No

How long do you quarantine stock (fish, invertebrates, plants, etc) before adding them to your tank? *

Approximate date of last new addition of anything (fish, invertebrates, plants, etc) to your display tank? *

What was the last new addition to your display tank? *

Type of Filtration System *

What type of lighting do you have and what is the length of time it is on? *

What is your tank water turnover rate through your filtration system/sump? *

Can you send us a picture of your tank or describe the setup (ex. Mounds of rock, bare bottom with no rocks, PVC pipe for fish to hide in, etc)?

Click or drag a file to this area to upload.

Or describe the setup (ex. Mounds of live rock, bare bottom with no rocks, PVC pipe for fish to hide in, etc)

Caring medicine for all animals.

If you live in Valparaiso or the surrounding area and need a trusted veterinarian to care for your pets – look no further. Arbor View Hospital Team is a licensed IN veterinarian, treating all types of pets. Your pets’ health and wellbeing are very important to us, and we take every possible measure to give your animals the care they deserve.

Location

244 West U.S. Highway 6
Valparaiso, IN 46385
Click here for directions.

Hours

Monday: 8:00am – 8:00pm
Tuesday: 8:00am – 8:00pm
Wednesday: 8:00am – 6:00pm
Thursday: 8:00am – 8:00pm
Friday: 8:00am – 6:00pm
Saturday: 8:00am – 1:00pm
Sunday: Closed

Contact Info

Phone: (219) 762-7267
Fax: (219) 763-9425
Email: arborviewah@gmail.com

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