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Home » Reptile/Amphibian History Form

Reptile/Amphibian History Form

Name

Species

Age

Sex

Background Information

Length of time owned

Where acquired?

Breeder

Pet Store

Other

When was last shed?

Was it normal?

Yes

No

Unknown

How often handled?

Daily

Weekly

Monthly

Never

Ever taken outside?

Yes

No

Other pets?

Yes

No

If yes, specify

Housed together or singly?

If not together, where?

Any new additions?

Yes

No

Were new animals quarantined?

Yes

No

Husbandry

Housed

Indoors

Outdoors

Where is cage located?

Type of caging

Size of caging

Cage substrate

How often is cage cleaned?

What type of cleaner?

How is cage heated & what temp?

Basking site?

Yes

No

Temp

Lighting

UV

Fluorescent

Incandescent

None

Unknown

How often are lights changed?

Yearly

Every 6 months

Other

Nutrition

Pellets

Yes

No

If yes, what brand/type?

Amount/Freq

Insects

Yes

No

If yes, what type?

Amount/Freq

Hay

Yes

No

If yes, what brand/type?

Amount/Freq

Vegetables

Yes

No

If yes, what type?

Amount/Freq

Supplements or Treats offered

Amount/Freq

Water Source

How often changed?

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(805) 495-1059

3575 Thousand Oaks Blvd,
Westlake Village, CA 91362

Make An Appointment

About Us
New Clients
Services
Requests
Contact Us
How Did We Do?
- Review Us
- What Can We Improve