Get the free PREOPERATIVE INSTRUCTIONS Form #9905 Rev

PREOPERATIVE INSTRUCTIONS Form #9905 Rev. 10/10-Page 1 of 1 PATIENT NAME: LAST FIRST MIDDLE EMAIL DOB / / SEX PHONE INSURANCE ALLERGIES PRECEPT.# NUMBER OF DAYS AUTHORIZED ADMIT STATUS: HSC Himself

How to fill out preoperative instructions form 9905

How to fill out preoperative instructions form 9905:

1. Start by opening the preoperative instructions form 9905 that you have received from the medical facility. Make sure you have a pen or pencil handy to fill out the form.
2. Begin by carefully reading through the form to familiarize yourself with the sections and instructions. Pay close attention to any specific guidelines or requirements mentioned.
3. Start by filling in your personal information in the designated fields. This typically includes your full name, date of birth, address, and contact information. Make sure to write legibly and provide accurate details.
4. Next, proceed to the section that asks for your medical history. Fill in any relevant information about past surgeries, known medical conditions, allergies, and medications you are currently taking. Provide as much detail as possible to ensure accurate and safe care during your procedure.
5. If the form contains sections for the surgeon or anesthesiologist to fill out, leave those fields blank. These sections are usually meant for medical professionals to complete.

Now, let's move on to the second part of the content:

Who needs preoperative instructions form 9905:

1. Patients scheduled for surgery: The preoperative instructions form 9905 is typically required for individuals who are scheduled to undergo any form of surgical procedure. It helps the medical team gather necessary information about the patient's medical history and ensures that they are fully prepared for the upcoming operation.
2. Outpatient surgery centers: The form is often used by outpatient surgery centers to streamline the preoperative process. It helps them collect important details about the patient's health, previous surgeries, and current medications, allowing them to provide the best possible care during the surgical procedure.
3. Hospitals and medical facilities: Preoperative instructions form 9905 is frequently utilized by hospitals and other medical facilities to comply with regulatory requirements and facilitate effective communication between patients and healthcare providers. It helps ensure that all necessary information is documented accurately and that patients receive appropriate preoperative care.

Remember, it is vital to consult with the specific medical facility or healthcare provider to determine if the preoperative instructions form 9905 is required for your surgery and obtain any additional instructions for filling out the form accurately.

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