Reptile History Form Name Of Reptile*Species*Sex*Age*Background InformationLength of time ownedWild-caught/Captive Bred?*YesNoWhere acquired?How often is animal handled?DailyOccassionallyNeverIf reptile is taken outside, for how long?When was last shed?Any trouble shedding?HusbandryType of enclosureSize of enclosureWhere is cage located?Cage furnitureCage Substrate?How often is cage cleaned?What type of disinfectant is used when cleaning cage?Cage EnvironmentLight cycleType of lightingHeat sourceHumidity levelTemperature within cageMinimumMaximumBasking areaNutritionType of food offeredAmount fed/frequencyWhen last fedWater SourceAny other pets?YesNoIf yes, specifyAny other reptiles?YesNoIf yes, specifyReptiles are housed together or singly?TogetherSinglyIf not housed together, where are the other animals located?Any new additions to the reptile population?YesNoIf yes, specifyPast Medical History/ProblemsCurrent Presenting ProblemsDuration of Complaint
