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Preoperative Health Questionnaire 1. Are you Diabetic? YES / NO 2. Are you currently on dialysis? YES / NO 3. Are you currently taking any of the following medications for glaucoma: GRAVATAR LUCIAN
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How to fill out pre-operative health questionnaire

01
Read the pre-operative health questionnaire carefully.
02
Fill out all the necessary personal information such as name, date of birth, and contact details.
03
Provide accurate information about your medical history, including any past surgeries, allergies, and chronic conditions.
04
Answer all the questions honestly and to the best of your knowledge.
05
If you are unsure about any question, consult with your healthcare provider before filling it out.
06
Make sure to include any current medications you are taking, including dosage and frequency.
07
If you have any specific concerns or questions, you can add additional notes or comments in the designated section.
08
Review the completed form to ensure all the information is accurate and complete.
09
Submit the filled-out pre-operative health questionnaire to the healthcare provider or facility as instructed.

Who needs pre-operative health questionnaire?

01
Anyone who is scheduled to undergo a surgical procedure or medical intervention needs to fill out a pre-operative health questionnaire.
02
This includes both elective surgeries as well as emergency procedures.
03
Patients of all ages, from children to adults, may be required to complete the questionnaire.
04
The purpose of the questionnaire is to assess the patient's overall health, identify any potential risks or complications, and ensure the safety and success of the procedure.
05
By gathering information about the patient's medical history, allergies, current medications, and other relevant factors, healthcare providers can make well-informed decisions and tailor the treatment accordingly.
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A pre-operative health questionnaire is a form that patients fill out before undergoing a surgical procedure to provide their medical history and current health status.
Any individual scheduled for a surgical procedure is typically required to fill out a pre-operative health questionnaire.
Patients can fill out a pre-operative health questionnaire by providing accurate information about their medical history, current medications, allergies, and any existing health conditions.
The purpose of a pre-operative health questionnaire is to assess the patient's health status, identify any potential risks or complications, and tailor the surgical plan accordingly.
Patients are typically required to report their medical history, current medications, allergies, previous surgeries, existing health conditions, and any known risk factors.
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