Eye Surgery Center - Physician Order, #572261 Hartford Hospital Physician Order Forms - harthosp: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering the patient's name, date of birth, and date of service in the designated fields at the top of the form.
In the PRE-OPERATIVE ORDERS section, check the box to admit the patient to Hartford Hospital Eye Surgery Center.
For POST-OPERATIVE ORDERS, indicate vital signs monitoring frequency and check any applicable boxes for procedures on either eye.
List any allergies and specify anesthesia preferences by checking the appropriate options.
Fill in medication orders as needed, including pain management medications and topical solutions. Ensure to specify dosages and frequencies.
Complete additional orders such as IV Heplock insertion and post-operative instructions before signing off with RN and MD signatures.

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