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Forms

Here is a listing of some of the forms you will need at the Rochester Regional Health Linden Surgery Center. 

Click on the title of the form to download a Microsoft Word Document of the form.

Pre Op Health History For Patients

The pre-operative Health History form should be completed by the patient using the link below at least 3 business days prior to surgery.  This information allows the Rochester Regional Health Linden Surgery Center to provide an assessment of each patient prior to coming in for surgery.

A nurse will call anesthesia patients regarding the information on the Health History to ensure all relevant information is gathered and understood.

 

One Medical Passport

 

Frequently Asked Questions - About Surgical Site Infections 

 

Anesthesia Consent Form

This is the form each patient receiving anesthesia will be required to sign on the day of surgery following discussion with the anesthestist.

 

Surgery Consent Form

Each patient will be required to sign this consent form which is ususally signed in your surgeon's office when the determination for surgery is made.  In the event it was not signed at the surgeon office, patients will be required to sign the form prior to surgery.

 

Health Care Proxy

The Health Care Proxy is a standard form for the patient in the event they want to complete one and have it on file.  This is not required by the Rochester Regional Health Linden Surgery Center.

 

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     © 2018 Rochester Regional Health-Linden Surgery Center   10 Hagen Drive, Suite 110 Rochester, NY 14625  (585) 267-8200