Surgical Form

306 Veterinary Clinic in Canyon Lake, TX uses this surgical form to gather important information before veterinary procedures. Sharing patient history, contact details, and owner acknowledgments helps our team prepare for surgery with clear communication and organized records.

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Surgical Care Information

Please complete this form before your animal’s surgical appointment. Provide accurate patient details, medication history, contact information, and any concerns you want our team to review.

Name *

First

Last

Phone *

Email *

Pet's Name *

At 306 Veterinary Clinic, our greatest concern is the well-being of your pet. Your pet is scheduled for an anesthetic procedure. Before putting your pet under anesthesia, we routinely perform a full physical examination. In order to maximize patient safety, we highly recommend, and sometimes require, a pre-anesthetic blood profile. The surgeon may be alerted to the presence of certain conditions that could complicate the procedure, such as dehydration, anemia, infection, diabetes, and/or kidney or liver disease. These tests are similar to what your own physician would conduct prior to you undergoing anesthesia and help ensure the administration of the most appropriate anesthetic regimen.

The Complete Blood Count (CBC) and Pre-Anesthetic Profile includes: CBC [PCV (anemia), white blood cell count (infection), red blood cell count (anemia/bleeding disorder), and platelet count (clotting disorder)] and Chemistry Profile [BUN and creatinine (kidney), ALKP and ALT (liver), glucose (sugar), total protein (dehydration), and electrolytes (imbalance)].
The owner elects to decline the recommended pre-anesthetic blood tests at this time but requests that we proceed with the procedure.

Other tests are available that are not included in the above choices. The tests selected above give the doctor a suitable overview of healthy patients. For those patients who are sick or in their senior years (above the age of 9), a full senior profile can be performed the day of the procedure with the doctor’s recommendation or at the owner’s request.

Our ability to minimize anesthetic and surgical risks and maximize patient safety is greatly enhanced by the completion of a physical examination and bloodwork prior to a surgical procedure. If you have any questions or concerns about the scheduled procedure, please do not hesitate to call or email (830) 935-2229 / 306vetclinic@gmail.com to discuss any aspect of the upcoming procedure.

Dear Client,

Your pet is scheduled for an upcoming surgery.

If you have any questions, please feel free to call or email the hospital at (830) 935-2229 / 306vetclinic@gmail.com. On your pet's surgery day, you will be required to review and sign an Authorization/Estimate Form. We will also double-check to ensure we have a phone number where you can be reached during your pet's surgery time.

The night before your pet’s surgery, we ask that you refrain from providing any food or treats after 10:00 pm. Water is fine and may be left out for your pet to consume. If you are currently administering any medications, vitamins, and/or injections, withhold the morning doses unless otherwise instructed by the doctor.

At the time of your pet's scheduled surgery, the doctor will address any remaining questions or concerns you may have and will collect the Authorization Form that you have completed.

If you have elected to have any of the recommended blood tests performed, these will be collected and done prior to the start of surgery, if not already performed in advance. If any questions arise, the doctor may contact you at the number on the Authorization Form.

Upon the completion of the surgery, the doctor will process your payment, go over all discharge orders verbally, and provide you with a written copy. If you do not understand any instructions, please do not hesitate to ask for clarification before you leave the clinic or after you return home.

We know surgery days can induce stress and anxiety. 306 Veterinary Clinic appreciates the trust you place in us, and we want to make the experience as pleasant as possible for both you and your pet.

We look forward to serving you and your pet on the upcoming surgery day.

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Surgical Form

Surgical Care Information

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