Where is the reptile kept in the house?

Enclosure

Cage: type,size

What is on the bottom of the cage?

What types of hiding places are provided?

List species of live plants

Is there a soaking/swimming tub?

Please describe any other furnishings

How often is the cage cleaned, and what cleaning products are used?

Aquatic Species

How often is the water changed?

What type of filtration is used?

Do you use a dechlorinator or any other type of water treatment?

Lighting

Does your reptile receive sunlight?

Estimated hours per week

Does the sunlight pass through glass or plastic before reaching the reptile?

Artificial Lighting

Incandescent(“screw-in” bulbs )

Fluorescent (Tube bulbs )

How often are the fluorescent bulbs changed?

Temperature

Do you have a thermometer(s) in the cage?

What is the temperature in the warmest part of the cage and In the coolest part?

Is there a thermostat?

Is the temperature decreased at night?

By how much?

Humidity

Is the cage misted?

How Often?

Is the humidity measured?

Range

How much time does your reptile spend outside of the enclosure?

Is your reptile supervised when it is out?

Is supplemental heating provided outside the cage?

Type

Have you ever noticed your reptile eat any household objects?

Is the reptile ever taken outside?

Does your reptile hibernate? Please describe the duration, temperature, and monitoring that you provide during hibernation.

Do you have other pets?

Recent acquisitions (new pets within the past 6 months) – species, date,source:

List any other pets you have

Are any of your other pets ill?

List recent changes in the environment, if any:

Diet

What percent of your reptile’s diet consists of the following (please describe what the animal actually eats, rather than what is offered)

Vegetables, fruits %, list types Insects, mealworms, etc. %, list types

Are they “gut loaded” or dusted before feeding to your reptile? Describe

Rodents, chicks, etc. %, list types & source

Are they fed

Pellets, commercial diet or canned food % list types

Other %, Describe

How often do you feed your reptile?

Please list any supplements used. How are they given and how often?

Does your reptile eat anything other than its intended diet (e.g. the cat’s food, houseplants)?

How is water offered (e.g. dish, misting, drip system)?

Please list any recent additions/changes in the diet:

When was the last shed?

Was it normal?

Reptile History Form