Call us today!
303-688-4690
pets@franktownanimalclinic.com
Facebook
Twitter
Facebook
Twitter
Home
About
About
Team
K-9 Friends
Careers
Services
New Clients
New Clients
Client Information Form
Forms
Client Information Form
Patient Appointment Form
Surgery Drop Off Form
Contact
Blog
Travel Certificates
Appointment
Select Page
Surgery Drop-Off Form
Complete your surgery drop-off questionnaire below.
Please enable JavaScript in your browser to complete this form.
Today's Date
*
Pet's Name
*
Owner's Full Name
*
First
Last
Phone
*
E-mail
*
Surgery Type
Surgery Date
List any other procedures or concerns:
Do you want a phone call before any dental extractions?
Yes
No
If this is a Mass Removal - Do you approve sending the mass out for Histopathology?
Yes
No
Has your pet had any food in the last 12 hours:
What medications or supplements are you giving?
Does your pet need to refill or start Heartworm prevention?
ANESTHESIA AND GENERAL RELEASE
I authorize Franktown Animal Clinic to use all reasonable means to care for my pet. I understand that all anesthesia involves some risk to my pet and will not hold Franktown Animal Clinic liable for any issues that may occur. I authorize pain management which may include anti-inflammatory and/or pain medications, acupuncture, as well as therapeutic laser treatment.
*
I have read this statement and I agree.
Email
Submit