Academy of Surgical Research



Academy of Surgical Research

Surgery Case Log

Date

|Species/Study Number |Sex |Weight (lbs) |Age |Procedure Performed |Survival/non-Survival |Complications |Euthanasia Date/Method |Primary/Assistant Surgeon |Comments | |      |      |      |      |      |      |      |      |      |      |      | |      |      |      |      |      |      |      |      |      |      |      | |      |      |      |      |      |      |      |      |      |      |      | |      |      |      |      |      |      |      |      |      |      |      | |

Candidate Signature: ________________________________________ Date: ___________________________

Veterinarian or Qualified Personnel: ________________________________________ Date: ___________________________

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