Post-Surgery Assessment Form

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Your Name*

Your Email Address*

Best phone number to reach you*

Your Pet's Name*

What surgical procedure did your pet have done?*

What date (or how many days ago) was this procedure?*

We typically aim to conduct our post surgical assessments 10 -14 days after a procedure.

Overall how do you feel your pet did after surgery?*

Did your pet receive all of their prescribed medications as directed?*

Yes
No

If NO, what medications did you give and for how long? Was there a reason you were unable to give the medications as prescribed?

Has your pet received any other medications, treatments or supplements in the 10-14 days since their surgery?*

Yes
No

If YES, what other medications, treatments or supplements has your pet received since their surgery?

How well were you able to limit your pet's activity after surgery?*

How do your pet's surgical incisions look? If there is redness, swelling, discharge, or you have any concerns about how they look, please describe in more detail.*

Has your pet been licking, chewing or scratching at their surgical incision(s)?*

Did you find your pet to be comfortable and pain free in the days and week after surgery?*

Has your pet's energy, personality and appetite returned to normal? If not, please elaborate*

Has your pet had any coughing, sneezing, vomiting or diarrhea in the past 7 days?*

Is your pet a puppy or kitten between 5 and 12 months old?

Yes
No

If YES, It may be time to talk about transitioning from a puppy/kitten diet to an adult diet. To help us determine if this is recommended, please describe what you feed them now (brand, formula and flavour), and the quantity they eat each day.

Please attach a picture of your pet's incision site

If you have technical difficulties attaching a picture to your form, please email it to care@bloorcourtvetclinic.com, with a note that you are sending it to accompany their Post-Surgery Assessment form.

Security Question*

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY **

Post-Surgery Assessment Form

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