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GUNDOGdoc
Clinic Hours: 605-334-2412 • After Hours Emergency: 605-977-6200
Home
About Us
Our Story
Staff
FAQs
BLOG
Services
Specialty and Advanced Care
Sports Medicine & Rehab
Specialty Surgery
Preventative Care & Wellness
For Clients
Testimonials
Contact
GUNDOGdoc
Surgery Admission Form
Please answer ALL questions as completely as possible
Pet Name
*
Owner Name
*
Date of Surgery
*
Please list ALL surgical procedures that you are expecting to be performed on your pet. If applicable, please specify which leg (e.g. left front) and the location of any masses to be removed.
CURRENT HEALTH:
Please evaluate the following signs in your pet over the past few days:
(1) Appetite
*
NORMAL
ABNORMAL
If abnormal, please describe:
(2) Vomiting
*
YES
NO
(3) Stools / Defecation
*
NORMAL
ABNORMAL
If abnormal, please describe:
(4) Coughing
*
YES
NO
(5) Breathing Pattern
*
NORMAL
ABNORMAL
If abnormal, please describe:
(6) Urination
*
NORMAL
ABNORMAL
If abnormal, please describe:
(7) Energy Levels
*
NORMAL
ABNORMAL
If abnormal, please describe:
PREVIOUS SURGERY / ANESTHESIA:
Has your pet ever had general anesthesia performed before?
*
YES
NO
If yes: Did your veterinarian report any complications during the anesthesia or recovery period?
YES
NO
If yes, please describe:
Did your pet make a full recovery from the anesthesia within 24 hours?
YES
NO
If no, please describe:
Please list your pet's previous surgeries with approximate date (if any):
Contact Us
Name
*
Email
*
Message
*
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3209 S. Summit Ave
Sioux Falls, SD 57105
P:
605.334.2412
E:
After Hours Emergency:
605-977-6200