Surgical Procedure Request

Surgery Request Form

Please complete the following information to request a surgical procedure for your pet. Separate requests are required for each pet and each procedure. We ask that you read and review the following Surgery Scheduling Policies as detailed below.
Client Name*

First NameLast Name
Primary Phone #*
Please enter a valid phone number.
Primary Phone is a Cell#?*

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Primary Contact Email
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Patient Information
Pet Name*
Patient Information*
Surgery Type Requested

Terms, Conditions & Agreement

Please review details below
Southern Hills Animal Hospital surgical procedures are booking at least 2 months in advance.

Due to the amount of time and preparation required for all procedures, "No Shows" and last minute cancellations can cause numerous problems and added expense for the office - and prevent another patient from receiving their much needed treatment.

SOUTHERN HILLS ANIMAL HOSPITAL SURGICAL POLICIES
Surgery Requests are the first step in scheduling your pet's procedure. After a surgical request has been submitted, our office will contact you with our first available surgical date.

A Surgical Scheduling Fee of $125 is required to schedule and confirm your pet's procedure. This payment will hold a spot for surgery on the date selected. This amount will be applied to the total due on the day of surgery, which is due in full at time of pick-up.

If you need to change the date of the reservation, you will need to contact us at least 2 business days prior to your pet's scheduled procedure date in order to keep the Scheduling Fee active. Late cancellations or surgery "No Shows" will require an additional Scheduling Fee to re-schedule.

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PRE-SURGICAL MEDICATION
After the surgical date has been confirmed, we will prescribe your pet a medication called Cerenia. This medication is included in the price of your pet's surgery (no additional cost), and is used to prevent nausea that can be related to anesthesia.

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THE DAY OF YOUR PET'S SURGICAL PROCEDURE
Please arrive at 8:30 am on the morning of your pet's scheduled surgery date. This allows our medical team enough time to examine and prepare your pet for surgery. Surgical procedures include 1 night of boarding if you need to drop off the afternoon prior (please arrange ahead of time). At time of drop off, you will meet with the technician briefly to review the pre-surgical paperwork and consent forms; our team will be happy to answer any questions or concerns you may have.

In most cases, your pet will be ready to go between 4:30pm-5:00pm the day of surgery. If you are unable to pick up before we close at 5:30pm, your pet will be boarded with us overnight.

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PLEASE FOLLOW ALL POST-OPERATIVE INSTRUCTIONS TO ENSURE A FULL RECOVERY.

If your pet goes home with an e-collar, please be sure to keep the e-collar on at ALL times until the sutures are removed (10 days minimum) to avoid any delays in healing.
I confirm that I understand the Surgical Requests &Scheduling Policies detailed in this document, and agree to place the SurgicalScheduling Fee of $125.00 to reserve the date for my pet’s procedure.*

Yes
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Surgery Request Form

Patient Information

Terms, Conditions & Agreement