Reptile Information Form lnformation on ReptileType of reptileNameAgeSex (if knowHow long have you owned the reptile?From where did you obtain this reptile?Description (markings, scars,etc.)DietPrey foodVegetables (type & amount)Fruit (type & amount)Formulated DietHabitatHeat source: DaytimeHeat source: NighttimeDo you have a thermometer?What temperature is the cage?Do you have a heat rock?Ultraviolet bulb?Time of day bulb is onHow old is the bulbDate of other examinations or proceduresPertinent Medical HistoryHave you recently had any other reptiles come in contact with this one?lf yes, what species, how long ago, and were they ill?Is this reptile housed with any other reptiles?Reason for visit todayTo keep medical expenses to a minimum, we are unable to extend credit. How do you wish to pay for you professional services?CashCheckCredit Card
