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Patient Sticker REVISED 1/2016ANESTHESIA QUESTIONNAIRE AGEHEIGHTWEIGHTPRIMARY CARE PHYSICIANREASON FOR ADMISSION/ NAME OF PROCEDUREPROCEDURE DETOUR ANESTHESIA TODAY WILL BE ADMINISTERED BY Y N COMMUNICATION
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01
To fill out the wwwaanacompatientspre-anesformsia-questionnaireaana pre-anesformsia questionnaire, follow these steps:
02
Visit the website www.aana.com and navigate to the patients section.
03
Look for the 'Pre-Anesthesia Questionnaire' form and click on it.
04
Download the questionnaire form and open it on your computer or print it out.
05
Read the instructions and questions carefully.
06
Fill in the required fields such as personal information, medical history, and medications.
07
Provide accurate and detailed answers to the questions.
08
Once completed, double-check your entries for any errors or missing information.
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Save the filled-out form on your computer or print a copy for your records.
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You may need to bring the completed questionnaire with you to your upcoming anesthesia appointment.
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If you have any questions or need assistance, contact your healthcare provider or the AANA for guidance.

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The wwwaanacompatientspre-anesformsia-questionnaireaana pre-anesformsia questionnaire is for individuals who are scheduled for anesthesia for a surgical procedure. It is typically required by healthcare providers, anesthesiologists, and hospitals to gather important information about the patient's medical history, current health conditions, and medications. This questionnaire helps ensure the safe administration of anesthesia by allowing healthcare professionals to assess any potential risks, allergies, or complications that may arise during the procedure. It is important for patients to provide accurate and complete information on the questionnaire to help healthcare providers make informed decisions about their anesthesia care.
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The wwwaanacompatientspre-anesformsia-questionnaireaana pre-anesformsia questionnaire is used to gather medical history and information regarding anesthesia prior to a surgery or procedure.
Any patient undergoing a surgical procedure that requires anesthesia is required to fill out the pre-anesthesia questionnaire.
The pre-anesthesia questionnaire can be filled out online on the healthcare provider's website or in person at the facility.
The purpose of the pre-anesthesia questionnaire is to ensure the patient's safety during surgery by providing necessary medical information to the anesthesia provider.
The pre-anesthesia questionnaire must include details about the patient's medical history, current medications, allergies, and any previous experiences with anesthesia.
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