Get Baylor Medical Center Frisco Surgery Request/ Physician Orders Fax: 2144075125 Patient Name (name

Filling out the surgery request and physician orders form accurately is essential for efficient processing. This guide will provide you with clear, step-by-step instructions to ensure that all necessary information is completed correctly.

Follow the steps to complete the surgery request form effectively.

1. Press the ‘Get Form’ button to acquire the form and open it in the designated editor.
2. Begin by entering the patient's full name as it appears on their driver's license in the designated field.
3. Input the patient's Social Security number in the provided space.
4. Specify the pre-operative diagnosis accurately to ensure correct medical communication.
5. Fill in the surgeon's name, the date of the procedure, and the time of the procedure in the respective fields.
6. Select the anticipated patient status from the options provided. Consult the Case Manager if any questions arise regarding patient status.
7. Indicate the procedure to be performed. Ensure that it is detailed and clear.
8. Document the necessary CPT and ICD9 codes related to the procedure.
9. Complete the pre-surgery requests, including IV fluids and any specific tests (like blood sugar or pregnancy tests), if applicable.
10. Indicate whether an acute pain block is requested and if a frozen section is required.
11. If grafts or tissue are needed, check the appropriate boxes and provide specifications for size and other details.
12. Mention any special needs or requests, such as instruments to be delivered, along with vendor name and contact details.
13. Estimate the length of the procedure and fill in the anesthesiologist's name.
14. Ensure that the physician signs the document, along with the date and time.
15. Input patient information, including date of birth, age, gender, and address, as well as contact numbers.
16. Detail whether the patient has visited Baylor Medical Center at Frisco before.
17. Complete the policy holder information with the necessary details related to the insurance.
18. Finally, check all entries for accuracy to ensure the form is correct before saving, downloading, or printing it.

Begin completing your documents online today for efficient processing.