PRE-OPERATIVE INSTRUCTIONS

Patient Name: ____________________________ MM#:_________ Date:________

Surgery Date:__________________ Surgery time:_____________A.M./P.M.

Procedure: □ C/S □ Tubal □ LEEP □ Laparoscopy □ Hysterectomy

Other:________________________________

You MUST be present in the hospital two (2) hours before your scheduled surgery time. Your arrival time is:__________________A.M. / P.M.

DO NOT eat or drink anything, including alcohol, after midnight the night before your surgery and nothing the morning of your surgery. Failure to follow this instruction could result in the cancellation of your surgery.

Report to admissions on your scheduled date of surgery. It is required that all paperwork and testing be completed prior to your hospital admission/surgery.

Please do not smoke before or after your surgery.

DO NOT wear jewelry or bring valuables with you to the hospital.

If you take medication routinely for any condition, ask your physician whether to take it the day of the surgery. Usually you will take the medication.

Remember to wear comfortable clothing. After surgery, tight clothing will be uncomfortable and could create difficulty in getting dressed. Do not wear shoes with high heels or that are difficult to get on.

You will be required to have a responsible adult of your choice to accompany you to the hospital and upon discharge. Failure to have this person available could result in your admission the hospital overnight at your expense.

You may be asked to remove your glasses, contact lenses, piercings or dentures. Please bring your container to the hospital with you for their safekeeping

Notify your physician of any change in your physical condition such as a bad cold, sore throat, rash, fever or cough.

A parent or legal guardian must accompany a minor to the hospital for a scheduled surgical procedure.

Please DO NOT bring children with you. Our hospital does not have facilities or personnel to provide adequate supervision for your children while you are in surgery

Make-up and nail polish should not be worn the day of scheduled surgery. ► Additional information and POSTOP instructions can be found on our website- www.aristaobgyn.com

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