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858-247-3406
6030 Santo Rd #A, San Diego, CA 92124
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Surgery Consent Form
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Book Appointment
Home
About Us
Location & Hours
Meet The Team
Reviews
Photo Gallery
Services
Pet Wellness Care
Pet Vaccines
Pet Dentistry
Pet Diagnostics
Pet In-House Laboratory
Pet Laser Therapy
Pet Surgery
Online Pharmacy
Client Center
Our Blog
Our App
FAQs
Payment Options
Forms
New Client Form
Dental Consent Form
Patient Drop-Off Form
Surgery Check-In Form
Surgery Consent Form
Pre-Surgical Instructions
Appointment Policy
Join Our Team
Contact Us
Book Appointment
New Client Special: Receive 50% off your first exam!
M
Online Forms
Surgery Check-In Form
Our forms are available to fill out at anytime online. Fill out your surgery check-in form here.
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Surgery Check In Form
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Owner's Name
*
First
Last
Patient's Name
*
Phone
*
I consent to receive SMS text messages from The Pet Hospital of Tierrasanta. Msg & data rates may apply. Reply STOP to opt-out.
*
Yes
No
Email
*
Surgery/procedure you wish to have performed:
*
When did you pet eat last?
*
Is you pet currently taking any medications?
*
Yes
No
Please list medication(s) and when the last dosing was:
Please list any personal belongings:
*
Do you need refills on any prescription pet food?
Yes
No
If you need a prescription pet food refill, please let us know which kind:
Did you want any additional services performed while your pet is here (i.e. vaccines, anal gland expression, heartworm test)?
Yes
No
Please list additional services desired:
Signature
*
Clear Signature
Please note: there is a $3.00 per minute charge for pets picked up after closing (6 pm).
Date
*
Message
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