Get the free Pre-site Questionnaire - Surgery-Re-Evaluationdoc

Print Form CHILDREN IS MEDICAL SERVICES CARDIAC SURGICAL SERVICES REEVALUATION FORM Facility A. Date FACILITY VOLUME YES NO 1. 150 pediatric cardiac surgeries are performed annually. # Performed Comments:

How to fill out pre-site questionnaire - surgery-re-evaluationdoc

How to fill out the pre-site questionnaire - surgery-re-evaluationdoc:

1. Start by carefully reading through the entire questionnaire to familiarize yourself with the questions and requirements.
2. Begin filling out the questionnaire by providing your personal information such as your name, date of birth, contact information, and any relevant medical history.
3. When answering the medical history section, be thorough and accurate. Include any previous surgeries, current medications, allergies, and any other information that may be important for the evaluation.
4. If there are any specific instructions or guidelines provided within the questionnaire, make sure to follow them closely. This may include providing additional documentation or medical records.
5. Take your time to answer each question carefully and honestly. Remember that the purpose of this questionnaire is to gather necessary information for the surgery re-evaluation, so being truthful is crucial.
6. If you come across any questions that you are unsure about or that do not apply to you, reach out to the healthcare professional or the designated contact person for clarification.

Who needs the pre-site questionnaire - surgery-re-evaluationdoc:

1. Patients who are scheduled for a surgery re-evaluation may be required to fill out this questionnaire. It is a standard procedure to assess the patient's medical history and ensure their suitability for the upcoming surgery.
2. The pre-site questionnaire is typically necessary for both new patients and those who have previously undergone surgery, as it helps the healthcare team gather important information for evaluation and decision-making.
3. It is essential for patients to complete the pre-site questionnaire accurately and honestly to assist the healthcare professionals in assessing their condition and making informed decisions regarding their surgery.

Note: The specific requirements and procedures for filling out the pre-site questionnaire - surgery-re-evaluationdoc may vary depending on the healthcare facility and the circumstances of the individual patient. It is always recommended to carefully read and follow the instructions provided in the questionnaire and consult with the relevant healthcare professionals if needed.

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