Pre Surgical Screening Questionnaire

Pre Surgical Screening Questionnaire

Pre Surgical Screening Questionnaire

Pre-Surgical Screening Questionnaire

Questions before your appointment to help us serve you better.

Owner Information


Pet's Name

Phone Number

Email Address

Is your pet currently taking any medications? If so, please bring medications with your pet.

Does your pet need to be fed tonight?

Any allergies to medications/foods?

Questions regarding treatment plan (cost)?

If a pet is being sent home with medications, which is easier for you to administer? (Not all requests can be accommodated)

Do you want your pet microchipped during the procedure?

Do you have any time constraints for picking up your pet? Normal discharges are late afternoons.

Do you think your pet would benefit from medication to keep them calmer during recovery?

Would you like us to perform life saving techniques if your pet requires them?

If your pet is having a mass removal, please download the below map and place an X on the body map to indicate where the mass is located.
Dog Map Cat Map

At Port Royal Veterinary Hospital in Port Royal, SC, our experienced doctors and staff are proud to offer complete veterinary medicine catered to the specific needs of your pet.