Loving Family Vet - Reptile Care Sheet

1
General Information
2
Species
3
Date of Birth (or suspected age)
Date
Year
Month
Day
4
Sex
M
F
Unknown
5
How long have you had this pet?
6
Cage dimensions?
7
Is this cage shared with any other pets?
Yes
No
8
If yes, what is that pet’s species, gender and age?
9
Cage construction and materials (please check all that apply)
Glass (aquarium, terrarium)
Wood
Plastic
Screen
Other
10
if Other, please specify
11
Cage contents (please check all that apply)
Hide box
Rock
Live plants
Plastic plants
Humid hide/hut
Other
12
if Other, please specify
13
What substrate do you use on the bottom of the cage?
Soil
Bark
Shavings/wood chips
Carpet/Astroturf
Newspaper
Paper towels
Sand
Other
14
If Other, please specify
15
How often is the cage cleaned?
16
How often is the cage disinfected?
17
Disinfectant used?
18
Please list all food items, and their approximate percentage of the total diet
Food items
Percentage
Food items
Percentage
Food items
Percentage
Food items
Percentage
19
Frequency of feeding (daily, every other day, weekly, etc)
20
Do you gut load insects before feeding?(feed nutritious food items or formula to insects prior to feeding them to your reptile)
Yes
No
21
If yes, what is currently being fed?
22
Please list any dietary supplements(Calcium, Multivitamin,etc) used
Supplement
Brand
Frequency
#
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
#
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
#
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
#
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
#
#
#
#
Supplement
Row 0, Column 0
Brand
Row 0, Column 1
Frequency
Row 0, Column 2
Supplement
Row 1, Column 0
Brand
Row 1, Column 1
Frequency
Row 1, Column 2
Supplement
Row 2, Column 0
Brand
Row 2, Column 1
Frequency
Row 2, Column 2
Supplement
Row 3, Column 0
Brand
Row 3, Column 1
Frequency
Row 3, Column 2
1 of 4
23
Enclosure Temperature range
Cool Side Temperature
Hot Spot Temperature
24
How is temperature measured?
Temperature Gauge Type
Location
25
Do you decrease the temperature for seasonal hibernation? If yes, please describe
26
Heating method (please check all that apply)
Heat bulb (fluorescent, ceramic, halogen, etc.)
Heating pad/tape
Heat rock
Radiant Heat panel
Other
27
if Other, please specify
28
Photoperiod : Total hours of light each day
29
Lighting method
Filtered sun (through a window)
Direct sun light
Room light
UVA/UVB linear light
UVA/UVB spot light
Fluorescent/Incandescent bulb (NO UVB)
30
how often is it changed? UVA/UVB
brand? UVA/UVB
31
how often is it changed? Fluorescent/incandescent
brand? Fluorescent/incandescent
32
Percentage
Humidity Percentage (If unknown, compared to the room humidity is it: lower, same, higher)
How is the Humidity Percentage measured?
33
Is a humid hide used? (area of high humidity)
Yes
No
34
How is water offered (please check all that apply)
Bowl
Spray/mist
Rain or drip system
Other
35
if Other, please specify
36
Date of last fecal examination
Date
Year
Month
Day
37
Any parasites identified?
38
Date of last shed
Date
Year
Month
Day
39
Was it normal?
40
Any past illnesses? If yes, please describe condition and when it occurred
41
Any other reptiles in your home that have been sick?
42
Any new reptiles in the house?
43
Email
example@example.com
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