Submit A Case

Please email Dr Lockwood at lockwood@vetsurgeryofgeorgia.com if you have not heard back within 24hrs.

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Clinic Name *

Clinic Number *

Clinic Email *

Doctor *

Client Name *

Client Email *

Client Phone (Primary) *

Client Phone (Secondary)

Patient Name *

Age *

Sex *

Breed *

Weight (kg or lb) *

Problem (indication for surgery) *

History *

Physical Exam Findings *

Radiographs done? *

• Yes
• No

If Yes, provide link below or type "emailed" if you are emailing images to lockwood@vetsurgeryofgeorgia.com

Is there a particular day or week that you and/or the pet owner would prefer for surgery? *

Would you like to schedule this patient for

• Surgery
• In-person consultation alone
• In-person consultation with surgery same day

In-person consultations are $180. If surgery alone is scheduled, I will call the owner after I have examined the patient on the day of surgery.

Other Diagnostics

Heart disease? *

• Yes
• No

If Yes, please indicate diagnosis and medications

Other pertinent medical history or conditions?

Submit