Form
Type or name of animal
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date Of Birth
-
Month
-
Day
Year
Date
Are you employed? If so, Where and for how long.
How did you hear about us?
Are there children under the age of 18 regurlary in your home?
Yes, They live here
No, No children here
Yes, They visit and may spend nights here
If there are children in the home, Please provide ages below.
Who will be the primary caregiver for this pet? daily care and financially.
Are there other pets in the home?
Yes
No
If Yes, Please provide the pet information : Type of pet , Breed of pet, age of pet
Will the above mentioned pet(s) have contact with the adopted reptile/amphibian? What precautions will be taken if decided to introduce your new pet?
What type of home do you live in?
Townhouse
Apartment
single family
Other
Do you Rent or own your home
Rent
Own
My landlord knows and consents to the reptile/amphibian living on the rented property
Yes
No - Not yet
Land Lords Name
First Name
Last Name
Land Lords Email
example@example.com
Land Lords Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How you ever owned a reptile or amphibian before? If so, How long?
Have you ever or ever plan to breed reptiles? If so when have you or when do you plan to?
Please describe the lighting required for this pet? How often must it be changed?
I have already purchased the correct lighting and will provide proof at the end of this application
Yes.
Please describe the enclosure your reptile will be living in? What is it made of? What is the substrate?
I have already purchased the correct forever home enclosure and substrate for my reptile. I will be able to provide proof at the end of the application
Yes
Please describe the feeding schedule, supplement schedule and diet you wi1l be providing for your new reptile?
I have purchased the supplements and have a food source for my reptile
Yes
What are the proper temps for your lizard? Basking, Humidity , ambient, and cool side.
Are you established with a vet? If so do they see and specialize in reptiles as well?
If not, Please provide information of at least two vets within your area that may provide care for your reptile when necessary
I understand that reptiles and amphibians vet care are not the same as other animals and that they need specialized care
*
Yes
What are the proper temps for your lizard? Basking, Humidity , ambient, and cool side.
I agree that all information stated above is correct
if I am unable to care for the reptile/amphibian properly I will surrender it back to A Dragon's Den
I am able and prepared to take my reptile to the vet when needed and for yearly physicals
All enclosures and lighting are and will remain up to date and of top quality
I understand the importance of gut loading insects and proper UVB
I agree that NO child will hold or play with this reptile unsupervised
I agree to properly feed and nurture this animal
My Reptile/ Amphibians set up enclosure
My reptiles suppliments
My reptiles lightbulbs
Signature
Submit
Should be Empty: