Patient Forms

Patient Health Questionnaire

Anesthesia and surgery affect your entire body, so it is important for your anesthesiologist to know as much about you as possible. This questionnaire will help us determine whether you will need lab work or other tests prior to the day of surgery. A member of our staff will call you prior to the day of surgery to obtain additional information and provide important instructions pertaining to your visit.

Unless instructed otherwise, you will meet your anesthesiologist immediately before your surgery and he will review your entire medical history and perform a brief physical examination. You will also be informed of the anesthetic choices, their risks and benefits and options for post-operative pain relief.

All prescription medications should be taken on the day of surgery with a small sip of water unless instructed otherwise by your physician or a member of our staff.

Fill Out the Patient Health Questionnaire

Patient Satisfaction Survey

We hope your experience at Audubon Surgery Center was as comfortable and convenient as possible, and we are interested in your assessment of our service. Please take a moment to complete this survey and return it to us in the enclosed envelope. Your comments and suggestions will help us evaluate our services. Thank you for your assistance.

Fill Out the Patient Satisfaction Survey