Reptile History Questionnaire

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MM slash DD slash YYYY


Has your pet ever had a problem in the past?


Do you have other reptiles?

Are they in the same cage as this one?

Is your pet at room temperature?

Do you control the temperature and humidity of the cage?

Does your pet get exposed to unfiltered sunlight at least a few days a week? (Not through glass or plastic; screen is ok)

Do you use a UVA/UVB bulb?

Is the bulb over 6 months old?


How much is your pet eating?

Do you gut load (feed supplements) to your pet's insects?

How much is your pet drinking?

Do you give vitamin/mineral supplements directly?

Shedding and Behaviors

Is your pet shedding regularly?

Was it full or partial?

Do you mist or soak?

Additional Information

In order for our doctors to do a complete analysis for a diagnosis, do we have your permission to perform the following, if needed?
X-rays ($65)

Ultrasound ($45)

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This field is for validation purposes and should be left unchanged.

What's Next

  • 1

    Call us to schedule an appointment.

  • 2

    Meet with a doctor for an initial exam.

  • 3

    Put a plan together for your pet.