Lubbock Surgery Form | P.E.T.S. Clinic

P.E.T.S. of Lubbock Surgery Form

Date of Appointment*
MM slash DD slash YYYY

Please enter the date for which you set your appointment.
Owner Name*
Address*
Street Address City State ZIP Code
Email*
Cell Phone*
How Did You Hear About P.E.T.S.?*
- Friends or Family
- Google Search
- Facebook
Pet's Name*
Species*
- Dog
- Cat
Sex*
- Male
- Female
Breed*
Color*
Age*
I Would Like My Feral Cat To Receive an Ear Notch at No Charge. Owner MUST INITIAL.

By initialing above, you agree to have the ear notched of the feral cat you have brought in for service.
How Long Have You Had Your Pet?*
Where Did You Get Your Pet?*
Please List Current Medications Your Pet is on INCLUDING Flea & Tick.*
Has Your Pet Been Seen by a Veterinarian in the Past Six Months? If Yes, Please Explain What the Visit Was For. Include Routine Examinations.*
Please Tell Us About Previous Surgeries or Emergencies Involving Your Pet. Any other Concerns? (Exp. Breathing Trouble, Unexplained Swelling...Etc)*
Signature

By typing my name in the above field and submitting this form, 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 ten days. I also understand and agree that in the event I fail to pick up my pet after surgery, my pet will be taken to the animal reclaim center. P.E.T.S. Clinic is not able to board my pet. I understand my pet will receive a small green tattoo on their abdomen to indicate sterilization. I agree that any services in addition to the spay/neuter surgery agreed upon during drop off have been approved.
Email
This field is for validation purposes and should be left unchanged.

P.E.T.S. of Lubbock Surgery Form

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Guidestar

P.E.T.S. Low Cost Spay and Neuter Clinic