Please only use this form if directed to by a member of Lone Mountain Animal Hospital’s staff as this form is used to authorize us to check-in your reptile.

Owner's Information

Pet's Information

Where was the pet acquired? (required)
BreederPet StoreOther

Was the reptile caught in the wild or bred in captivity? (required)
Caught in the wildBred in captivity

Was the reptile deparasitized? (required)
YesNo

How often is the animal handled? (required)
DailyOccasionallyNever

Is the animal ever taken outside? (required)
YesNo

Is there any trouble shedding? (required)
YesNo

Reptile Husbandry

Cage Environment

Nutrition Information

Any non-reptile pets in the home? (required)
YesNo

Any there any additional reptiles in the home? (required)
YesNo

Are the reptiles housed together or not? (required)
YesNo

Any new additions to the reptile population? (required)
YesNo

Medical Information

Has the reptile visited a veterinarian before? (required)
YesNo

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About

Lone Mountain Animal Hospital to provide quality veterinary care with personal touch embrace compassionate progressive approach to needs of our patients.

Business Hours:

Mon-Sat 7:00am – 5:00pm
Sunday 8:00am – 4:00pm

Contact Us:

Phone: 702-645-3116
Fax: 702-645-2758
6688 W. Cheyenne Ave. Las Vegas, NV 89108

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