Owner's Name (required)
Owner's Phone (required)
Owner's Email (recommended)
Pet's Name (required)
Pet's Breed (required)
Pet's Sex (required)
Pet's Age (required)
Where was the pet acquired? (required)
Was the reptile caught in the wild or bred in captivity? (required)
Caught in the wildBred in captivity
Was the reptile deparasitized? (required)
If yes, what product was used?
How often is the animal handled? (required)
Is the animal ever taken outside? (required)
If yes, for how long?
Is there any trouble shedding? (required)
If yes, please describe.
Fecal Characteristics (required)
Type of enclosure, i.e. glass, vivarium, etc. (required)
Size of enclosure (required)
Where is the cage located? (required)
Cage furniture (required)
How often is the cage cleaned? (required)
What type of disinfectant is used to clean the cage? (required)
Light cycle (required)
Type of Lighting, i.e. UVB, natural, etc. (required)
Heat source (required)
Humidity level (required)
Temperature within cage. Please include maximum, minimum, and basking area temperatures. (required)
Type of food offered (required)
Amount fed/frequency (required)
Last feeding date (required)
Water source (required)
Any non-reptile pets in the home? (required)
If yes, please specify.
Any there any additional reptiles in the home? (required)
Are the reptiles housed together or not? (required)
If not housed together, where are other reptiles located?
Any new additions to the reptile population? (required)
Has the reptile visited a veterinarian before? (required)
If yes, what is the date of their last visit?
Past medical history/problems
Current presenting problems
Lone Mountain Animal Hospital to provide quality veterinary care with personal touch embrace compassionate progressive approach to needs of our patients.
We accept CareCredit as a form of payment.
6688 W. Cheyenne Ave. Las Vegas, NV 89108
Check (with Photo ID)
CareCredit (Card and PayMyProvider)