Reptile History Form (OR)

Please fill this out before you bring your scaled friend into our office. This will speed up the intake process and let us get to work sooner.

 
1 Start 2 Complete
General History
Visual, surgical, probe, laid eggs?
Housing
Please also describe approximate dimensions (3ft x 1.5ft, 40gal, etc.)
If so, what is the humidity and how is it measured?
Light, heating pad, heat rock, etc?
If so, where are they located and what are the high and low end temperatures?
Please provide the brand and how often you replace it
Please describe
Please describe
Please describe. Also, how long have they been together?
If so, where and for how much time?
If so, what frequency?
Please also list what products you use to clean the enclosure, if any.
Diet
Describe percentages if possible
If not, please describe where you feed your pet.
If so, what kind/brands and how often?
Medical History
General
Please describe