Get Form 3870

Form 3870 is a crucial document used within the medical field, particularly for preoperative assessments involving pacemaker and ICD procedures. This guide will provide clear and structured steps to assist users in completing the form online, ensuring all necessary sections are accurately filled out.

Follow the steps to complete Form 3870 online

1. Click ‘Get Form’ button to access the form and open it in your browser.
2. Begin by filling in the section for the preoperative nurse checklist. Ensure that the patient has been contacted and that the device has been correctly identified. Note the date, name, and time of contact with the CIED Clinical Specialist.
3. In the perioperative management checklist section, enter details including the manufacturer's name and the date the device was implanted.
4. Document the location of the implant and the date of the last interrogation of the device.
5. Indicate whether there is an alert status on the device by checking the appropriate box for 'Yes' or 'No'. Provide additional information if 'Yes' is selected.
6. Specify the indication for device placement clearly for future reference.
7. Select the device type by marking the corresponding box for either single chamber pacemaker, dual chamber AICD/pacemaker, dual chamber pacemaker, or biventricular AICD/pacemaker.
8. Enter the pacing rate, pacing threshold, and battery life status, selecting the options that best apply from the checkboxes provided.
9. Indicate whether the ICD function is active along with any additional notes regarding the magnet response or discharge frequency.
10. Complete the sections for signatures and dates for both pre-op and post-op interrogation of the device, ensuring to document the normal function and battery life.
11. Finally, review all entries for accuracy, then save changes, download, print, or share the completed form as required.

Complete Form 3870 online to streamline your medical documentation process.