Pre-operative History & Physical

Enclosed is a History and Physical form to be completed by your Family Physician.


Please make an appointment to have this form completed within Thirty (30) days of your scheduled surgery. Your Physician needs to Fax a copy of the form to the Hospital, and you need to talk the completed form with you on the day of your surgery.

If you are under the care of a Cardiologist or Pulmonary Physician, you will need to get a written medical clearance for them. Have you physician to fax to your office @ 246-2394.

If you have ANY PROBLEMS getting in to see your Physician and/ or getting the form completed; please contact the surgery scheduler @ (513) 246-2326.

PLEASE NOTE: Occasionally, as to gets closer to your surgery date the start time may need to be adjusted, for one reason or another. If this happens, you will be notified immediately.

If you need to cancel or reschedule your surgery please call the scheduler as soon as possible.

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