817-860-3087 technician@greenoaksnorthvets.com

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Please note: We are closing at 3:30 pm Friday 9/22 and will be closed this Saturday 9/23. We will reopen Monday 9/25 at 7:30 am.

Surgical History Form

Please fill out the following form before your scheduled procedure with us.

surgical history form

Surgical History Form

Thank you for choosing Green Oaks North Pet Hospital. In order to better serve your pet, please fill out the following form as thoroughly as possible. If you have any questions, please give us a call.

Name *

First

Last

Email *

Pet's Name *

Procedure Your Pet Is Receiving *

Anything else needed while pet is under anesthesia?

Emergency Phone Number *

Medical History

When and where were your pet’s last vaccines? *

When was your pet’s last Felv/Fiv test or heartworm test? *

Do you give your pet heartworm prevention? *

Yes
No

If yes, please list what kind and when given *

Has your pet recently experienced any vomiting, coughing, sneezing, or diarrhea? *

Yes
No

Has your pet been ill or injured within the last 30 days? *

Yes
No

If yes, list illness or injury *

Does your pet have any medical issues we have not previously addressed? *

Yes
No

If so, list: *

Is your pet allergic to any drugs? *

Yes
No

If yes, list drugs: *

Is your pet taking any medications (including aspirin)? *

Yes
No

If yes, list medication: *

When was medication last given? *

Do you want us to check any specific problems? *

Yes
No

If yes, list problems *

Do you regularly use dental hygiene products on your pet? *

Yes
No

If yes, list products *

I understand that I will still need to speak with a technician in person and go over a treatment plan. *

I agree.

Signature for surgical consent *

Message

puppy and kitten

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Ready for a visit?

We proudly serve the pets of Arlington, Grand Prairie, Euless, Viridian, and the surrounding areas. We look forward to seeing you and your pet! You may request an appointment by clicking the button below.

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We offer virtual care!

Address your pet’s health from the comfort of your home by quickly connecting with your veterinarian. Click here to download the Anipanion App from your app store.

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Find Us

1890 NE Green Oaks Blvd
Arlington, TX 76006

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Our Hours

Mon–Fri: 7:30 am to 7:00 pm
Sat: 8:00 am to 12:00 pm
Sun: Closed

Hours may vary on holidays

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Contact Us

817-860-3087 (phone)
817-860-3088 (fax)
technician@greenoaksnorthvets.com

Have a question?

Get in touch! Complete our online form, and a member of our team will be in touch with you shortly.

Name *

First

Last

Email *

Phone

How can we help you? *

Email

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