Pet's Name Age Sex M F Unknown Spayed/Neutered? Yes No Unknown Species Breed or morph if applicable Where did you obtain your pet? Wild-caught Captive bred Other How long have you owned them? Are they vaccinated? Yes No Please list.Current MedicationsPlease describe any supplements, how they are given, and frequencyReason for visit today, symptoms, and when it startedPast medical problemsAny changes to eating, drinking, urination, or defecation? When did they last eat and drink? Any abnormal stools? When did they last urinate? When did they last defecate? Other pets in household? Yes No If yes please describe type(s) and if they live with your pet here todayAny new pets recently? Yes No Does your pet go outside at all? Yes No Does your pet free roam in the house? Yes No Please describe their cage, pen, or living arrangement including type of bedding or substratePlease describe their diet with amounts and how often they are fedPlease describe any treatsPlease describe their water sourceFor reptiles and amphibians onlyLighting, type of bulbsOther heat sourcesDistance from bulb to basking spot Any glass or plastic in between pet and UVB bulb? How old is their UBV bulb if applicable How long is their UVB bulb on each day? MesurementsTemperature On cool sideTemperature Basking spotAmbient temperatureHumidityAny humidity supplementation (misting, Reptifogger, etc.)? CommentsThis field is for validation purposes and should be left unchanged.
