Template
Veterinary Surgical Safety Checklist Template
A three-step team checklist — before induction, before the first incision and before the patient leaves theatre — to fill in for every surgery.
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Clinic name
Address · Phone · Email
Surgical safety checklist
Patient
Patient name
Case / record no.
Species / breed
Weight (kg)
Owner
Date
Before induction
☐ Patient identity and procedure confirmed with the record☐ Consent form signed☐ Fasting status checked☐ Known allergies / alerts checked☐ IV access in place☐ Anaesthetic machine and equipment checked☐ Emergency drugs available
Before the first incision
☐ Team introduced and roles clear☐ Procedure and site confirmed☐ Antibiotic prophylaxis decision recorded☐ Expected critical events discussed☐ Sterility of instruments confirmed
Before leaving theatre
☐ Swab, needle and instrument counts correct☐ Samples labelled☐ Post-op analgesia and monitoring plan agreed☐ Recovery handover given
Notes
Checklist completed by — name & signatureDate
Template from WeVet — free veterinary resources
Frequently asked questions
Is this surgical safety checklist template free?
Yes. You can see the whole template on this page. Downloading it for Word / Google Docs or saving it as a PDF needs a free WeVet account.
Can I add my clinic's name and logo?
Yes. Download the Word version and edit it — the clinic details at the top are blank fields.
Is the wording legally approved for my country?
No template can be. Adapt consent and record wording to your national veterinary council and local regulations before using it.
Have a case in front of you?Ask WeVet — the AI assistant built for veterinarians. Differentials, treatment plans with calculated doses, drug info from trusted sources and SOAP notes.
Ask WeVet about thisFor veterinary professionals. Information supports — never replaces — clinical judgement; always check the current product label and local regulations.