Reptile History Form

Reptile History Form
- Name
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Name
- Species
- Sex
- Age
- Color/Markings
- How often is your reptile handled?
  
  DailyOccasionallyNever
- Do you have other reptiles?
  
  Yes, shared tankNoYes, separate tank
- Other reptiles in shared tank*
- Other pets in the household
  2 dogs, 1 cat, 2 chinchillas, etc.
- Where did you get your reptile?
- How long have you had your reptile?
- Any new additions to your reptile collection?
  
  YesNo
- New additions:
  boa, 2 weeks ago, etc.
- When was last shed?
- Any trouble with last shed?
- Fecal Consistency
- Where is enclosure located?
  inside/outside, which room, etc.
- What is enclosure made of?
  glass, wood, metal, etc.
- How big is the enclosure?
- What substrate do you use?
- Please list any decor, toys, wood, etc.
- Does your reptile ever go outside?
  
  Yes, supervisedNoYes, unsupervised
- Please elaborate on outside exposure
- What is used to clean the enclosure?
- How often is enclosure cleaned?
- Type of Lighting
- How often is bulb changed?
- Date of last bulb change
- Light Cycle
- Heat Source
- Humidity Level
- Temperature Within Cage
- Type(s) of Food Offered
- Amount Fed & Frequency
- When was your reptile last fed?
- How is water offered?
- Water Source?
  tap, bottle, etc.
- Upload any previous records, if applicable, and include any photos of your pet and their environment that may be helpful. We strongly recommend at least uploading a picture of their enclosure.
- File Upload
  
  Cancelof
- Should be Empty: