Skip to content

There is major construction taking place along Commonwealth Avenue throughout 2025. Please take this into account to ensure your pet arrives on time.

617-332-7030 Call

Make an Appointment

Home
Our Hospital
Services
Client Center
Resources
Online Pharmacy
Referring Veterinarian Info Center
Contact Us

Home
Our Hospital
Services
Client Center
Resources
Online Pharmacy
Referring Veterinarian Info Center
Contact Us

617-332-7030 Make an Appointment

Home » Surgery Intake Sheet

Surgery Intake Sheet

For our Spay & Neuter form, please click here.

Patient Name(Required)

Client Name(Required)

First

Last

What procedure(s) is your pet here for today?(Required)

Have you reviewed the estimate for this procedure?(Required)

Yes

No

Has your pet eaten anything at all in the last 10 hours?(Required)

Yes

No

If yes, please list them below:(Required)

Has your pet been given any medications, supplements, or treatments during the past 7 days?(Required)

Yes

No

If yes, please list them below:(Required)

Has your pet had any vomiting, diarrhea, coughing or lethargy in the past 7 days?(Required)

Yes

No

If yes, please explain it below:(Required)

Do you have any new health concerns about your pet?(Required)

Yes

No

If yes, please list any new health concerns below:(Required)

Do you anticipate that there will be any problems keeping your pet quiet and on-leash/indoors for the next 10-14 days?(Required)

Yes

No

Has your pet ever had a past anesthetic event that you thought went poorly?(Required)

Yes

No

If yes, please explain it below:(Required)

For dental procedures, are you aware that extractions may be necessary?(Required)

Yes

No

For growth removals, how many growths are being removed today?(Required)

If your pet is NOT coming in for a growth removal, please put 0 or n/a

Does your pet have any food allergies?(Required)

Yes

No

Which heartworm/Flea/Tick preventative is your pet on?(Required)

Will you be available by phone or text all day?(Required)

Yes

No

If no, please explain in the box below(Required)

Is your voicemail set up and able to receive messages?(Required)

Yes

No

If no, please explain in the box below(Required)

Best Daytime Contact Number:(Required)

Signature(Required)

Name(Required)

Make an Appointment

Find Us

Online Pharmacy

PetDesk

Make an Appointment 617-332-7030

2285 Commonwealth Ave.,
Newton, MA 02466

Online Pharmacy PetDesk

Business Hours

Monday

8:00am - 7:00pm

Tuesday

8:00am - 7:00pm

Wednesday

8:00am - 6:00pm

Thursday

8:00am - 7:00pm

Friday

8:00am - 6:00pm

Saturday

8:00am - 3:00pm

Sunday

Closed

©Copyright 2025 - Newton Vet - Commonwealth Veterinary Hospital. Sitemap | Privacy Policy

Cookies on this website are used to both support the function and performance of the site, and also for marketing purposes, including personalizing content and tailoring advertising to your interests. To manage marketing cookies on this website, please select the button that indicates your preferences. More information can be found in our privacy policy here.

X