Surgery History Form

Owner Name *

Pet's Name *

Email Address *

Cell Phone *

What surgery is your pet having? *

Please list any past surgeries your pet has had:

During the surgery, your pet will be placed under anesthetic sedation to keep them comfortable. How has your pet handled being put under sedation in the past?

Handled it well
Had some issues
Never been under sedation
Not sure

Please list all medications and supplements your pet is on and when they were last given (please also include those not prescribed by Fredericton Animal Hospital):

What food does your pet typically eat?

Does your pet have any behavioural issues?

Biting
Timidness
Needing special handling
Other

Would you like any additional services while your pet is at the hospital? (additional charges may apply)

Placement of a microchip to identify your pet if missing
Updates to any due vaccines
Refills on any current prescriptions
Refills on parasite medication (Revolution, Nexgard)
Purchase food

Your pet's surgery will typically be completed by early afternoon. We will contact you with a post surgery update BETWEEN 11am and 2pm. How would you like to be contacted? *

Phone Call
Text Message

Please bring to your appointment all medications your pet is currently taking. Thank you!

Security Question *

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY *