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NewYorkPresbyterian The University Hospital of Columbia and Cornell Department of Perioperative Services Preoperative Medical Questionnaire Assessment Data Form IF NO PLATE, PRINT NAME, SEX AND MEDICAL
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How to fill out pre-op medical questionnaire

01
Begin by carefully reading the pre-op medical questionnaire provided by your healthcare provider. Make sure to understand each question and what information is needed.
02
Gather all relevant medical records and documentation, such as previous surgery reports, test results, or scans. Having these documents handy will help you provide accurate and detailed information.
03
Start filling out the questionnaire by providing your personal information, including your full name, date of birth, and contact information. This allows the healthcare team to identify you correctly and reach out if needed.
04
Answer all questions honestly and to the best of your knowledge. It's essential to provide accurate information about your medical history, current medications, allergies, and any previous surgeries or procedures you have undergone.
05
If you don't understand a question or need clarification, don't hesitate to reach out to your healthcare provider or their staff. They will be able to provide guidance and ensure you complete the form correctly.
06
Pay attention to any special instructions or additional documents that need to be attached to the questionnaire. This may include consent forms, insurance information, or any specific requirements for your upcoming surgery.
Who needs pre-op medical questionnaire?
01
Individuals who are scheduled to undergo a surgical procedure, regardless of the type of surgery, may be required to fill out a pre-op medical questionnaire. This is done to ensure that the healthcare team is aware of any pre-existing medical conditions or medications that may impact the surgical procedure.
02
People with chronic medical conditions, such as diabetes, high blood pressure, heart disease, or lung disease, may have a more extensive pre-op medical questionnaire to provide a comprehensive overview of their health status.
03
It is common for elderly individuals to be asked to fill out a pre-op medical questionnaire as they may have a higher likelihood of having multiple medical conditions and taking multiple medications.
Taking the time to accurately fill out a pre-op medical questionnaire is crucial as it aids in the identification of potential risk factors, allows the healthcare team to adequately prepare for the surgery, and ensures the best possible outcome for the patient.
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What is pre-op medical questionnaire?
A pre-op medical questionnaire is a form filled out by patients before they undergo surgery, to provide important information about their medical history, current medications, and any known allergies.
Who is required to file pre-op medical questionnaire?
All patients scheduled for surgery are required to fill out a pre-op medical questionnaire.
How to fill out pre-op medical questionnaire?
Patients can usually fill out the pre-op medical questionnaire provided by their healthcare provider either online or on paper, answering all the questions accurately and truthfully.
What is the purpose of pre-op medical questionnaire?
The purpose of the pre-op medical questionnaire is to help healthcare providers assess the patient's health status, identify any potential risks or complications during surgery, and ensure the patient's safety.
What information must be reported on pre-op medical questionnaire?
Information such as medical history, current medications, allergies, previous surgeries, and any existing health conditions must be reported on the pre-op medical questionnaire.
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