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An Ambulatory Surgery Perioperative Surgical Home in
Kaiser Permanent Settings: Practice and Outcomes
Hunan AIU, MD, MS, * Joseph Reinhart, MD, VU T. Nguyen, MD, * Maxime Cannes son, MD, PhD,
Ate
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How to fill out an ambulatory surgery perioperative
01
Start by reviewing the ambulatory surgery perioperative form to familiarize yourself with the sections and information required.
02
Begin filling out the form by providing your personal details, such as your name, date of birth, and contact information.
03
Move on to the medical history section and provide accurate information about any pre-existing conditions, allergies, or previous surgeries.
04
If you are currently taking any medications, make sure to list them in the appropriate section. Include the name, dosage, and frequency of each medication.
05
Next, provide information about your emergency contact person. Include their name, relationship to you, and their contact details.
06
Proceed to the surgical information section and provide details about the specific procedure you are undergoing. Include the name of the surgery, date, and any additional details requested.
07
If you have any questions or concerns, leave a section blank or provide notes in the designated area for additional comments.
08
Review the completed form for accuracy and make any necessary edits or corrections.
09
Sign and date the form to certify that the information provided is true and accurate.
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Submit the completed ambulatory surgery perioperative form to the appropriate healthcare provider or facility.
Who needs an ambulatory surgery perioperative?
01
Anyone who is scheduled for an ambulatory surgery needs to fill out an ambulatory surgery perioperative form.
02
This includes individuals of all ages who are receiving surgical treatment on an outpatient basis.
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The form ensures that the healthcare providers have access to the patient's relevant medical history, current medications, and emergency contact information.
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