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Background: Much of the work on fish welfare focuses on areas prior to arrival at the home aquarium. Fish owners may have questions regarding the health and well-being of their fish, and they likely return to the point of purchase to get relevant fish health information. Methods: A phone survey was administered to a random sample of North Carolina stores that sell pet fish. The purpose was to determine the role of pet store personnel as primary care providers and the frequency with which pet store personnel were likely to offer a medical opinion for a sick fish. Results: Of the 27 pet store employees that provided consent, 23 (85.2%) provided a medical opinion, one employee (3.7%) was unsure and offered no opinion, and the other three (11.1%) recommended a referral to an avian/exotics veterinarian. For the 23 locations that suggested a medical opinion, the most common recommendation was an over-the-counter medication (73.9%). Three (13%) felt the issue described needed no additional treatment while two (8.7%) recommended changes to husbandry or environment. Only one (4.3%) respondent that provided a medical opinion or presumptive diagnosis recommended a veterinarian. Conclusion: Some pet stores may provide information that may negatively impact pet fish welfare.