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Exotics Intake

Exotics Intake Form

Basic Information

Type of Pet *

Reptile

Bird

Small Mammal

Species *

Pet Name *

Sex *

Male

Female

Unknown

Age (or estimate)

How long have you had your pet? *

Where did you obtain your pet? *

Housing & Environment

Type of enclosure (tank, cage, free roam, etc.) *

Size (approximate) *

Substrate/bedding *

Cleaning frequency *

Does your pet spend time outside enclosure? *

Yes

No

If yes, describe

Temperature / Environment (Reptiles only)

Day temp

Night temp

Basking temp

Do you monitor temperature?

Yes

No

Humidity / Water

Humidity (if known)

Water source (bowl, bottle, misting, etc)

Water changed

Daily

Every few days

Less often

Lighting

Special lighting (heat lamp, UVB, etc.)

Yes

No

If yes, type/brand

Hours of light per day

Diet

What does your pet eat? *

How often do you feed? *

Supplements used

Calcium

Vitamins

None

Other diet details

Activity & Behavior

Any recent changes?

Yes

No

Appetite

Energy level

Other concerns

Medical History

Previous veterinarian *

Current medications *

Known health issues *

Ever checked for parasites? *

Yes

No

Unknown

Current Concerns

What are you here for today? *

Captcha

If you are human, leave this field blank.

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1245 NY-146
Clifton Park, NY 12065

Fax: (518) 383-0156

MON - FRI 8 a.m. - 8 p.m.
SAT 8 a.m. - 5 p.m.
SUN Closed

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