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 *FirstLastPhone *E-mail *Surgery TypeSurgery DateList any other procedures or concerns: Do you want a phone call before any dental extractions?YesNoIf this is a Mass Removal - Do you approve sending the mass out for Histopathology?YesNoHas 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. CommentSubmit