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Get and Sign Pre Surgery Forms 2012-2022

Get and Sign Pre Surgery Forms 2012-2022

Use a pre op clearance form pdf 2012 template to make your document workflow more streamlined.

Identified H&P: … per PCP … per PCP, may use hospitalists if not available … per hospitalist … per surgeon: date_____ … General Anesthesia: PAT/SDS RN to check if criteria met If IDDM or greater than 50 years old … 12 lead EKG- within 30 days of surgery If greater than 75 years old … EP1- within 30 days of surgery If on Warfarin … PT/INR If in Renal Failure … Potassium on Admission If Diabetic … Glucose on Admission … MAC Anesthesia: If in Renal Failure … Potassium on Admission If Diabetic …...
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