Form preview

Get the free Pre-operative Medical History

Get Form
This document is a pre-operative medical history form designed for patients scheduled for anesthesia. It collects essential information about the patient\'s medical background, previous surgeries, and any concerns related to anesthesia. The form includes questions about personal and family medical history, medications, allergies, and lifestyle habits pertinent to the anesthetic process.
We are not affiliated with any brand or entity on this form
4,4
98,753 Reviews
4,5
11,210 Reviews
4,6
715 Reviews
4,6
789 Reviews

Get, Create, Make and Sign pre-operative medical history

Edit
Edit your pre-operative medical history form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your pre-operative medical history form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit pre-operative medical history online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the guidelines below to benefit from the PDF editor's expertise:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit pre-operative medical history. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Get your file. When you find your file in the docs list, click on its name and choose how you want to save it. To get the PDF, you can save it, send an email with it, or move it to the cloud.
Dealing with documents is always simple with pdfFiller.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
Learn more about security & compliance
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out pre-operative medical history

Illustration

How to fill out pre-operative medical history

01
Begin with your personal information, including full name, date of birth, and contact details.
02
List any current medical conditions or diagnoses, including chronic illnesses.
03
Document any previous surgeries and the dates they were performed.
04
Note any allergies, particularly to medications, foods, or environmental factors.
05
Outline any medications you are currently taking, including prescription and over-the-counter drugs.
06
Specify your alcohol and tobacco use, including the frequency and quantity.
07
Mention any family history of health issues that might be relevant to your surgery.
08
Complete any additional sections regarding social history or lifestyle choices, if applicable.
09
Review all information for accuracy before submitting the form.

Who needs pre-operative medical history?

01
Patients scheduled for surgical procedures.
02
Individuals undergoing anesthesia requirements for surgery.
03
People with underlying health conditions that may affect surgical outcomes.
04
Anyone who has had previous surgeries that could impact future procedures.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.6
Satisfied
51 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Once your pre-operative medical history is ready, you can securely share it with recipients and collect eSignatures in a few clicks with pdfFiller. You can send a PDF by email, text message, fax, USPS mail, or notarize it online - right from your account. Create an account now and try it yourself.
The pdfFiller apps for iOS and Android smartphones are available in the Apple Store and Google Play Store. You may also get the program at https://edit-pdf-ios-android.pdffiller.com/. Open the web app, sign in, and start editing pre-operative medical history.
Use the pdfFiller mobile app to fill out and sign pre-operative medical history on your phone or tablet. Visit our website to learn more about our mobile apps, how they work, and how to get started.
Pre-operative medical history is a comprehensive account of a patient's past and present medical conditions, medications, allergies, and surgeries that is documented before undergoing a surgical procedure.
Patients scheduled for surgery are required to file their pre-operative medical history, which is typically completed by them and reviewed by the healthcare provider.
To fill out pre-operative medical history, patients should accurately provide details about their medical history, including current medications, existing health conditions, past surgeries, allergies, and any other relevant medical information, often using a standardized form provided by the healthcare facility.
The purpose of pre-operative medical history is to assess the patient's overall health, identify any potential risks related to anesthesia or the surgical procedure, and ensure the safety and effectiveness of the planned surgery.
The information that must be reported includes personal identification details, medical conditions, allergies, current medications, past surgical procedures, family medical history, and any other relevant health information.
Fill out your pre-operative medical history online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview

Pre-Operative Medical History is not the form you're looking for?Search for another form here.

Related Features

Finish Logo in the Summer Camp Physical Form with ease
Finish Logo in the Trainee Daily Progress Report with ease
Cancel Trademark in the Indemnification Agreement with ease
Cancel Trademark in the Peer Review Report with ease
Remove Emblem in the Service Invoice Template with ease

Relevant keywords

pre-operative medical history anesthesia patient information surgery health assessment allergies medications anesthetic concerns health conditions

Related Forms

Form preview
form imm 5406
Pto/sb/94 (02-09) approved for use through 02/29/2012. omb 0651-0036 u.s. patent and trademark office; u.s.
Fill Now
Form preview
uspto customer number lookup
Pto/sb/125a (11-08) approved for use through 11/30/2011. omb 0651-0035 u.s. patent and trademark office, u.s.
Fill Now
Form preview
PTO/SB/38
This form is used to request the u.s. patent and trademark office (uspto) to retrieve
Fill Now
Form preview
can i email an applicant initiated interview request form
Find fillablearmytarptrainingcertificatejobs at
Fill Now
Form preview
REQUEST FOR ACCESS TO AN ABANDONED APPLICATION ... - uspto
Pto/sb/68 (02-10) approved for use through 07/31/2012. omb 0651-0031 u.s. patent and trademark office; u.s.
Fill Now
Form preview
2014 provisional application for patent cover sheet form
Doc code: tr.prov document description: provisional cover sheet (sb16) pto/sb/16 (11-08) approved for use through
Fill Now
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.