803-905-9700 hudsonvethospital@gmail.com

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Reptile Patient Form

Please fill out the form below so we can get to know your pet reptile.

Exotics

Reptile Patient Form

Referring Veterinarian *

Client Name *

First

Last

Client Email *

Pet's Name *

Species *

Approximate Age *

Sex *

Male
Female
Unknown

How long have you had your reptile? *

Is your reptile: *

Wild Caught
Captive Bred

Housing

What type of enclosure does your reptile live in? *

What are the dimensions? *

Do you use a hydrometer (humidity meter)? *

Yes
No

If yes, what is the humidity? *

What is the temperature? (Day) *

What is the temperature? (Night) *

What is the temperature? (Basking Site) *

Do you use thermometers? *

Yes
No

Where are they located? *

Do you use a full-spectrum UVB bulb? *

Yes
No
Unknown

What kind of bulb is it? *

How often is it replaced and when was the last time? *

How long are the lights on/off (daytime)? *

How long are the lights on/off (nighttime)? *

Does your pet spend time outside of the enclosure? *

Yes
No

If yes, explain: *

What is the substrate/bedding? *

What is the water source? *

Are there plants, branches, or other climbing structures? *

Is there a hiding area? If so, what kind? *

Are there any other reptiles in the same enclosure? *

Yes
No

If so, what species? *

For Aquatic Species

How often do you change the water completely?

How often do you change the water partially?

Water temperature:

Do you use a water heater?

Yes
No

Does the aquarium have a filter?

Yes
No

Do you test water quality?

Yes
No

Diet

Please fill in the percentage of the total diet and types of food in each category that your pet actually eats:

Leafy Greens

Legumes/Beans

Fruits

Other Vegetables

Insects (Live)

Insects (Dried)

Rodents (Live)

Rodents (Frozen/Thawed)

Other (Including Treats)

How often do you offer food? *

Where do you feed your reptile? *

Do you add calcium or vitamin supplements to the food? *

Yes
No

(Yes) How often? *

If insects are fed, are they gut loaded?

Yes
No
Unknown

Miscellaneous

Do you soak or bathe your reptile? *

Yes
No

How often? *

Do they have any seasonal behavior changes?

Medical History

Has your reptile ever been checked for intestinal parasites? *

Yes
No

Has your reptile ever laid eggs? *

Yes
No
Unknown

How often does your reptile defecate? *

How often does your reptile shed? *

When was their last shed? Any shedding issues? *

Check any boxes that apply to your pet:

Mites
Anorexia
Lethargy
Limping
Wounds
Diarrhea
Inactivity
Vomiting
Weight Losshttps://hudsonveterinaryhospital.net/wp-admin/admin.php?page=wpforms-builder&view=fields&form_id=5052#
Shedding Problems
Increased Appetite
Deformed Limbs
Weight Gain
Difficulty Breathing
Decreased Appetite
Swollen Eyes

Is there anything else you would like us to know today?

Come Visit Us

We're excited to meet you and show you the level of care and expertise our team is here to welcome you with.

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2565 Broad St, Sumter, SC 29150

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hudsonvethospital@gmail.com

Hours

Monday–Thursday 8am–1pm, 2pm–5pm
Friday: 8am - 1pm
Saturdays & Sundays: Closed

After-Hour Emergency Care

Please note that we do not provide after-hour emergency care. If your pet has an emergency, please refer to South Carolina Veterinary Specialty and Emergency Care. Please find their contact information below:

803-561-0015
3924 Fernandina Rd
Columbia, SC 29210

Have a Question?

Use the form below, and we'll get back to you as quickly as possible. If you need immediate assistance during business hours, call us at 803-905-9700.

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Email *

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