Owner's Name* First Last Pet's Name* Species* Age/DOB* Sex* Male Female Unknown Where did you obtain your pet?* Is your pet wild caught or captive bred?* How long have you had your pet?* Have you had this species of pet before?* Yes No What type of enclosure is your pet in and rough dimensions?*Does your pet spend time outside of the enclosure?* Yes No Explain*What is their water source?* Are there any plants/bushes/sticks/climbing structures?* Is there a hiding or nesting area?* Yes No What kind?* Any other pets in the same enclosure?* Yes No What kind?* Any other pets in the house? Do they interact?*Any new changes at home?* Yes No Please explain*How often do you clean their enclosure?* Are they exposed to any candles, humidifiers, essential oil diffusers or the kitchen?* Yes No DietPlease describe your pet’s diet (seed, pellets, hay, homemade?), any treats?*Are they on any vitamins/supplements?* Yes No Brand/what kind, and how often?*How often do you offer food?* Do they have any seasonal behavioral changes?* Yes No Please explain:*Have they ever had any medical issues to your knowledge?* Yes No Please explain:*Have they ever laid eggs or given birth?* Yes No How often do they defecate?* How often do they shed (if applicable)? When was last shed? Any problems in past?What are your concerns today if any?Any other misc comments?
