If you don't know the answer to a question on this form simply write "unknown" as your answer. Phone Number Email * Pet's Name (if applicable) What Species Are You Bringing For An Exam? * Has your pet been seen at another veterinary clinic? * Does your pet have insurance? * 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, coral, 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 often do you do routine water changes? * How many gallons of water do you replace at each water change? * 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? * How often do you check your tanks water parameters (pH, salinity, kH, Nitrate, Nitrite, Ammonia)? * What test product(s) do you use to check your water parameters (brands/kits)? * What are your aquarium parameters? Salinity * pH * kH * Nitrite * Nitrate * Ammonia * Tank Temperature * Do you add anything to the tank routinely (ex. Iodine, calcium, magnesium, etc)? * How often (if applicable) are these additives monitored with a test kit to determine levels before/after adding? * Tank substrate? Live Rock? Coral? Do you have a quarantine tank? * How long do you quarantine stock (fish, coral, invertebrates, etc) before adding them to your tank? * What was the last new addition to your display tank? * Do you use any of the following with 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 live rock, bare bottom with no rocks, PVC pipe for fish to hide in, etc)