Register your reptile online

Your Name
Pet Details
Name of Pet
Species
Age
Sex

Male Female Not sure
Neutered

Yes No
Date acquired
Month Day Year
Source (e.g.Breeder / Pet Shop)
If previously owned do you have any details e.g. how long, where, kept diet, any husbandry concerns?
Any previous illnesses?
If your pet has been treated at another vets previously, please give us the details in advance of your appointment so we can obtain clinical notes.
Does your pets come into contact with any other pets, if so which ones?
Have any new pets been introduced, if so what and when?
Environment:

Please provide a photograph or basic drawing (including position of lights, heating, food bowls, thermometers and basking spots.
Size; length, height, width
Substrate (what's on the bottom!)
Do you use a thermometer?

Yes No
Does it measure maximum and minimum temperatures?

Yes No
How often do you measure temperatures?
What have been your recent temperature readings (state whether hotspot/coldspot)?
Do you measure humidity?

Yes No
How often?
What have your recent readings been?
Do you have a humidity chamber/hide?
Does your pet go outside?

Yes No
When and for how long?
Aquatic pets only:
What filtration system do you use?
How often do you change the water?
Do you test the water?
Do you treat the water with anything?
Lighting and heating
How many lights and heat lamps do you have?
For each light: What is the brand/make?
How long is it on for a day?
How far away is it from your pet?
When did you last replace the bulb (for lights)?
Food
What do you feed your pet?
Anything else?
Where do you get the food from?
Any supplements?
Do you dust any insects? With what?
Do you gut load any insects? With what?
How do you provide water?
Does your pet get baths? How often?
What is your concern regarding your pet's health?
If so for how long has this been going on? Are any other pets affected?
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This form is designed to cover the requirements of a wide range of reptiles. Some questions may not be relevant to your pets but for the vet to make a full assessment please answer as many questions as possible!
Should you prefer to print this form and bring it to us when you bring in your pet, click here to download form in pdf format
Ashfield House Contact Details

Address
142 Derby Road Long Eaton
Nottingham NG10 4ER

Email:info@ashvet.co.uk
Website:www.ashvet.co.uk
Phone: 0115 972 7050
Fax: 0115 946 3304

Register your reptile online

Pet Details

Lighting and heating

Food

This form is designed to cover the requirements of a wide range of reptiles. Some questions may not be relevant to your pets but for the vet to make a full assessment please answer as many questions as possible!

Ashfield House Contact Details