Surgical clearance form 2025

1. Click ‘Get Form’ to open the surgical clearance form in the editor.
2. Begin by entering the patient's name in the designated field. This ensures that all information is accurately linked to the correct individual.
3. Next, input the date of surgery/anesthesia. This is crucial for scheduling and coordination with medical staff.
4. Fill in the surgeon's name who is recommending medical clearance. This provides context for the medical review process.
5. Specify the proposed surgical procedure and type of anesthesia. Clear details help in assessing any specific requirements or risks.
6. Indicate any indications for medical clearance, which may include patient history or specific health concerns.
7. List any labs, tests, or diagnostics needed prior to surgery. This section helps ensure all necessary evaluations are completed.
8. Mark whether the patient is cleared for surgery by selecting 'Yes' or 'No'.
9. Provide recommendations for surgery/anesthesia and any additional comments that may be relevant.
10. Finally, have the examining physician print their name, sign, and date/time at the bottom of the form before submission.

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