Get Surgery Scheduling Form

Filling out the Surgery Scheduling Form online is a straightforward process that helps streamline the scheduling of surgical procedures. This guide provides step-by-step instructions tailored to ensure that you complete the form accurately and efficiently.

Follow the steps to complete the Surgery Scheduling Form online.

1. Click 'Get Form' button to obtain the Surgery Scheduling Form and open it for editing.
2. Begin by entering the patient's name in the designated field. Ensure the name is spelled correctly to avoid any scheduling issues.
3. Fill in the date and time of surgery. Use the date format provided to ensure clarity.
4. Include the surgeon's name, as well as the relevant CPT codes associated with the surgical procedure.
5. Describe the procedure in detail to provide context for the surgery.
6. Input the pre-operative diagnosis and the corresponding ICD-9 codes, if applicable.
7. Indicate if a frozen section request is needed by selecting 'Yes' or 'No.'
8. Specify if grafts or tissue are requested, selecting 'Yes' or 'No,' and detail any specifications related to these requests.
9. Note any special needs or requests in the space provided to ensure the surgical team is informed.
10. Input the name of the vendor for any instrumentation required during the surgery.
11. Select the patient status and indicate which labs are required, following the provided options and including any additional lab tests as necessary.
12. List any known allergies of the patient in the appropriate field.
13. Confirm that cardiac or medical clearance has been obtained and record the practitioner’s pre-operative appointment date.
14. Ensure the practitioner signs and dates the form to validate it.
15. Complete the patient demographics section, including gender, date of birth, age, social security number, and contact details.
16. Provide the insurance information, including the policy holder's details and any necessary authorization numbers.
17. Finally, confirm the surgery scheduler and pre-op details, completing all fields before proceeding.
18. Once all fields are filled accurately, save the changes, and download or print the completed form for your records.

Complete your Surgery Scheduling Form online today to ensure a smooth surgical scheduling process.