If you have a fish, please fill the form below up to 24h before your appointment. Each pet needs its own form! Thank you!

Date (mm/dd/yyyy) *

Client's name *

Names or IDs of fish

Fish involved- common name(s) *

Length of time group has been together *

Reason for appointment request *

Do you have a quarantine program for incoming fish?

• Yes
• No

Previous diseases diagnosed and treated and how long ago? *

How long has tank/pond been operating? *

How many gallons in the tank/pond?

Type of lighting

• Natural
• Incandescent
• Fluorescent

How many fish in the tank/pond?

Plants in the in tank/pond?

Do you test the water? How often? What tests? *

Water changes- how often in days or weeks? What % of total gallons? *

Types of food fed and frequency *

Any recent fish introductions? How long ago? *

What are you observing with affected fish? How long? Any mortalities? *

Please list any medications or chemicals used in the last 90 days

Are you an aquaculturalist (fish farmer)?

• Yes
• No

Submit