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Reptile Care Sheet
We would greatly appreciate it if you would take the time to complete this form in its entirety, so that we may learn more about how you provide care for your pet reptile.
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1
General Information
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2
Species
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3
Date of Birth (or suspected age)
Date
Year
Month
Day
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Sex
M
F
Unknown
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5
How long have you had this pet?
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6
Cage dimensions?
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7
Is this cage shared with any other pets?
Yes
No
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8
If yes, what is that pet’s species, gender and age?
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9
Cage construction and materials (please check all that apply)
Glass (aquarium, reptarium)
Wood
Plastic
Screen
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10
if Other, please specify
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11
Cage contents (please check all that apply)
Hide box
Rock
Live plants
Plastic plants
Humid hide/hut
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12
if Other, please specify
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13
What substrate do you use on the bottom of the cage?
Soil
Bark
Shavings/wood chips
Carpet/Astroturf
Newspaper
Paper towels
Sand
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14
How often is the cage cleaned?
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15
How often is the cage disinfected?
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16
Disinfectant used?
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17
Please list all food items, and their approximate percentage of the total diet
Food items
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18
Percentage
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19
Frequency of feeding (daily, every other day, weekly, etc)
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20
Please list any dietary supplements used
Calcium
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21
Frequency
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Brand
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Multivitamin
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Frequency
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25
Brand
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26
Other
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27
Temperature range
Low
High
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28
How is temperature measured?
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29
Do you decrease the temperature for seasonal hibernation? If yes, please describe
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30
Heating method (please check all that apply)
Heat bulb (fluorescent, ceramic, halogen, etc.)
Heating pad/tape
Heat rock
Radiant Heat panel
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31
if Other, please specify
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32
Photoperiod : Total hours of light each day
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33
Lighting method
Filtered sun (through a window)
Direct sun light
Room light
UVA/UVB bulb (Linear or spot light)
Fluorescent/incandescent bulb (NO UVB)
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34
how often is it changed? UVA/UVB
brand? UVA/UVB
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35
how often is it changed? Fluorescent/incandescent
brand? Fluorescent/incandescent
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36
Percentage
If unknown, compared to the room humidity it is: lower same higher
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37
Is a humid hide used? (area of high humidity)
Yes
No
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38
How is water offered (please check all that apply)
Bowl
Spray/mist
Rain or drip system
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39
if Other, please specify
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40
Date of last fecal examination
Date
Year
Month
Day
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41
Any parasites identified?
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42
Date of last shed
Date
Year
Month
Day
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43
Was it normal?
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44
Any past illnesses? If yes, please describe condition and when it occurred
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45
Any other reptiles in your home that have been sick?
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46
Any new reptiles in the house?
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