Animal Humane Society
Dental/Specialty Surgery Request Form
Dental and specialty surgeries are provided at Animal Humane Society's Golden Valley clinic.
After you submit your request, staff will contact you within 2 to 3 business days to confirm your appointment.
Name of requestor
Name of rescue organization
Patient’s name and any aliases that foster may be using for pet
After you submit your request, staff will contact you within 2 to 3 business days to confirm date and time of your appointment.
What surgical procedure are you requesting?:
Cherry eye repair
Please list any concerns, current medications, and/or additional services needed:
Do Not Fill This Out