Is my pet a cataract surgical candidate - Animal Vision Center of VA

IS MY PET A CANDIDATE FOR CATARACT SURGERY?

To determine if your pet is a candidate for cataract surgery, please complete and return this form to us today. We will follow up shortly to schedule a complimentary phone consultation.

Name*
First Last
Phone*
Email*
Veterinary Practice Name*
Patient Name*
Age*
Breed*
Lifestyle*
- Indoor
- Outdoor
When did your pet receive the cataract diagnosis?*
Any history of the problem, or other health conditions such as diabetes?*
Do you have any further questions, concerns, or additional information to share with Dr. Brookshire?*
List all current medications taken by patient:*
If available, attach any recent bloodwork (preferably in the last 30 days)
Drop files here or

Accepted file types: jpg, png, pdf.

Informational brochure by Animal Vision Center of Virginia: