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Reptile History Form

Your full name

Primary phone number

Pet's name

Length of time owned:

Sex:

Sex:
A
B
C

Neutered or Spayed?

Neutered or Spayed?
A
B
C

Has the animal ever laid egg/given birth?

Has the animal ever laid egg/given birth?
A
B
C

Where was the animal acquired?

Where was the animal acquired?
A
B
C
D

Origin:

Origin:
A
B
C

How often do you handle your reptile?

How often do you handle your reptile?
A
B
C

Do you take them outdoors?

Do you take them outdoors?

Do you have any other reptiles at home?

Do you have any other reptiles at home?
A
B

Have you added other reptiles to your collection?

Have you added other reptiles to your collection?
A
B

Have you had contact with reptiles outside your home in the last 30 days?

Have you had contact with reptiles outside your home in the last 30 days?
A
B

Do you own other animals (birds,dogs,cats, etc)?

Do you own other animals (birds,dogs,cats, etc)?
A
B