Billings Animal Family Hospital

Exotic Pet Questionnaire

First Name *

Last Name *

Email *

Phone *

Pet Information

Name of Pet *

Species *

Sex *

Male
Female
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Length Owned *

Who is the main caretaker? *

Pet's Age *

Source of Animal (example: breeder, store, friend, etc.) *

Known Background/History *

Describe the entire enclosure set up *

Please upload pictures of the entire enclosure setup, or bring them to the appointment.

Do you provide natural/behavioural enrichment? *

Yes
No
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Is your pet housed alone or with other animals? *

Housed Alone
With Other Animals
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Describe natural/behavioural enrichment you provide . *

If housed alone or with other animals, please describe what and how many. *

Describe any hides you provide. *

Describe the type of substrate provided. *

Do you use a mister? *

Yes
No
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Do you monitor temperature range? *

Yes
No
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Is UV light provided? *

Yes
No
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Water Source

What type of water source is provided?

Is it treated? *

Yes
No
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How often is it tested? *

How often do you clean/upkeep filter? *

How often/long/frequently do you soak? *

Diet provided (Iist everything)

What is the source of your pet's diet? *

What supplements do you give them? *

Do you gut load the insects? *

How are meals offered? *

Live or frozen prey? *

How often do you weigh them? *

What do you gut load the insects with? *

Activity / Exercise Provided *

Reproductive Status (Spayed/Neutered/Pregnant/Clutches laid) *