Consent to Surgery Emergency & Urgent Care 239-777-7387 (PETS) Consent to Surgery Form Please ensure to carefully complete this entire form, including the “CAPTCHA” check-box at the end before hitting “submit”. Required responses are marked with an asterisk (*). Please enable JavaScript in your browser to complete this form.Owner's First Name *Owner's Last Name *Owner's Email *Owner's Phone *Owner's Address *Patient's Name *Type of Animal *DogCatOtherBreed *Age or DOB *Sex *MaleFemaleColor *Describe Surgical Procedure *Medical Conditions *Current Medications *Pregnant? *NoYesToday's Date *12/12/22Signature *MessageSend Form