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Pre op checklist template 2026

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  1. Click ‘Get Form’ to open the pre op checklist template in the editor.
  2. Begin by entering the patient's name and date at the top of the form. This ensures that all information is accurately attributed to the correct patient.
  3. In the 'Scheduled Procedure' section, specify the procedure planned for the patient. This helps in tracking and verifying surgical details.
  4. Review and check off each item under 'History and Physical Examination Performed' and 'Labs and EKG Attached'. Ensure all necessary documents are attached for a comprehensive review.
  5. List any medications, including prescriptions, over-the-counter drugs, and herbal products. This is crucial for assessing potential interactions during surgery.
  6. Evaluate patient risk factors and prior anesthetic complications. Documenting these details aids in tailoring anesthesia plans effectively.
  7. Confirm that all processes have been performed by checking off items like 'Patient Identifier Checked' and 'Time-Out Prior to Procedure'.
  8. Finally, ensure that the orthopaedic surgeon signs at the bottom of the form to validate completion before proceeding.

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pre op checklist template

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