PETS Clinic Surgery Form

Transport to P.E.T.S. Clinic Wichita Falls leaves from the Young County Arena parking lot at 7:30 on the morning of your scheduled appointment. The P.E.T.S. van will return to the same spot for pick up at 4:00 the same day.

Cats must come to transport in a carrier and dogs must be on leash.

Surgery forms are submitted to the PETS Clinic ahead of your scheduled appointment. If you need to cancel or reschedule your appointment, please do so as soon as possible so that we can fill your spot, as there is usually a waiting list for appointments.

Pets do not need to fast prior to their spay/neuter surgeries and can have water and about 1/4 of their usual amount of food the morning of transport, though if your pet is prone to car sickness you may want to withhold food.

Dogs on transport must be under 6 years of age and under 70 lbs, as dogs over these limits are considered higher risk for transport and surgery and need to be scheduled in Wichita Falls and driven there by the owner. Dogs over 6 are required to have lab work prior to surgery, to make sure they are healthy for surgery.

You will receive a text or email to confirm your appointment several days prior to the appointment. You MUST confirm to hold your pet's spot.

Appointment Date:

Date

Owner Name:*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Area CodePhone Number

Alternate Phone Number:

Area CodePhone Number

FacebookGoogle SearchFriends & FamilyOther

Pet #1 Name*

DogCat

MaleFemale

Predominant Breed:*

Color(s):*

Age: blanks* months years

How much does your pet weigh? Approximate weight is ok.*

How long have you had your pet?*

Where did you get your pet?*

I would like my feral cat to receive an ear notch at NO charge. Owner must initial below:

It is important that our veterinarian be provided as much information as possible about your pet. Please answer the following quesitons. A minor issue to you could be very important to our vet. Please be thorough.

Please list current medications your pet is on INCLUDING flea and tick and heartworm preventatives:*

Has your pet been seen by a veterinarian in the past 6 months? If yes, please explain what the visit was for. Include routine examinations:*

If your pet has a current (within the year) rabies vaccine please tell us the month/year when the vaccine was received: blanks And please include the vet clinic/or veterinarian who gave the vaccine:blank Failure to provide proof of current rabies vaccine will result in your pet receiving an updated rabies vaccine at the time of surgery.

Please tell us about previous surgeries or emergencies involving your pet. Any other concerns: (breathing trouble, unexplained swelling, etc)*

Pet #2 Name

DogCat

MaleFemale

Predominant Breed:

Color(s):

Age: blanks months years

How much does your pet weight? Approximate weight is ok.

How long have you had your pet?

Where did you get your pet?

I would like my feral cat to receive an ear notch at NO charge. Owner must initial below:

It is important that our veterinarian be provided as much information as possible about your pet. Please answer the following quesitons. A minor issue to you could be very important to our vet. Please be thorough.

Please list current medications your pet is on INCLUDING flea and tick and heartworm preventatives:

Has your pet been seen by a veterinarian in the past 6 months? If yes, please explain what the visit was for. Include routine examinations:

If your pet has a current (within the year) rabies vaccine please tell us the month/year when the vaccine was received: blanks And please include the vet clinic/or veterinarian who gave the vaccine:blank Failure to provide proof of current rabies vaccine will result in your pet receiving an updated rabies vaccine at the time of surgery.

Please tell us about previous surgeries or emergencies involving your pet. Any other concerns: (breathing trouble, unexplained swelling, etc)

By signing below, I hereby agree that the highlighted procedures have been approved by me. I understand that with surgery and anesthesia there is a risk of illness and/or fatality. I accept this risk and consent to the surgical procedure for my pet. I agree to hold harmless and release from liability P.E.T.S. Clinic from any illness or fatality that results from my pet receiving the following treatment(s). To my knowledge my cat/dog is healthy and has not bitten anyone in the past 10 days. I also understand and agree that in the event I fail to pick up my pet after surgery, my pet will be turned over to the Humane Society. P.E.T.S. Clinic and HSYC are not able to board my pet. I understand my pet will receive a small green tattoo on their abdomen to indicate sterilization. Signature of Owner:*