Please RegisteR at least 72 HOURs PRiOR tO sURgeRY Your Checklist 3-5 Days Before Surgery Call the Pre-Operative Nurse to schedule an appointment for Pre-Procedure Registration and Testing at
(702) 477-6520. Your procedure or surgery may need to be cancelled if your pre-admission testing is not completed beforehand. This will require 1-2 hours of your time.
If required, you will be directed to:_____ Go to the Laboratory for blood draws_____ Go to Cardiology for an EKG_____ Go to Radiology for X-rays_____ Go the Respiratory department for Pulmonary testing (do NOT use inhaled medications four (4) hours prior to testing
The Day of Registration (please register at least 72 hours before Surgery) Bring your insurance cards, photo identification and durable power of attorney or advance directive if you
have one. If you choose “transfusion-free” surgery, please let the admitting representative know.
Bring your Registration Packet that includes the orders from your physician. The Day of the Procedure (also see the green “Day of Surgery” insert) Check in at Admitting at least TWO (2) hours before your procedure time. Payment of deductibles and
co-pays (or pre-payment for non-insurance covered services) will be made at this time.
Bring a list of your current medications (complete the green “Required Info for Surgery” insert)
If you have a pacemaker/defibrillator, please bring your card so the pre-operative nurse can photocopy it.
If you are going to be admitted to the hospital, please have your family keep your personal belongings until
Take a deep breath and relax! The employees who will provide your care are professionals who are genuinely concerned about your well-being. WHat tO DO tHe DaY BeFORe sURgeRY Blood Bank ID – If you are typed for blood when you pre-register, you will be given a red hospital ID bracelet that
tells us your blood bank number. Do not remove the bracelet. You may shower with it, but do not swim or take
Food/Beverages/Smoking – Do not eat, drink or smoke after midnight the night before your surgery unless otherwise
directed by your doctor. This includes gum, coffee, mints, ice chips and water. Required info for Surgery form – Please complete and bring the green Required Info for Surgery handout. This
includes a list of all medications you have been on in the last month – prescriptions, over the counter drugs, vitamins,
Medications – If you routinely take medication for any condition, please confirm with your physician or anesthesiologist
if you should take it the day of your surgery.
Diabetes – If you have diabetes, check with your physician about taking your scheduled medicines and/or insulin Glucophage – If you take glucophage (Metformin), check with your doctor for direction on when and if you should
stop taking it, as tests using intravenous contrast dye require this medication to be stopped for 48 hours after the
Change in your physical condition – If your physical condition changes (i.e. cold, fever, infection, open wound,
newly prescribed medication) or if you are unable to keep your surgery appointment, notify your physician. Valuables – Please leave jewelry (including piercings and toe rings), money, credit cards and other valuables at home.
If you wear dentures, glasses or hearing aids, please bring a labeled container for their safekeeping.
What to bring – Comfortable clothes to wear home after your surgery or upon discharge. A gown and slippers
will be provided. If you are having any type of breast surgery, bring a support bra without underwire. If you will be
admitted, bring your asthma inhaler and/or eye drops (if needed).
Arriving at the hospital – Please limit the number of people accompanying you to one or two. Encourage them to
bring something to pass the time. They will be able to visit you while you are in Pre-Op. They will be notified when
your procedure is done, although visitors are not allowed during your recovery. Please note that children should not
be left unattended in the waiting area at any time. Children under age 12 are NOT allowed to visit. Going Home – You MUST arrange for a responsible adult to drive you home after surgery and he or she MUST stay
with you for 24 hours. Your surgical procedure MAY BE CANCELLED if you do not have an adult with you.
tHe DaY OF sURgeRY
Take a thorough shower the morning of your surgery. Do not apply lotion, powders, oil, deodorant, perfume or cologne. Do not wear contact lenses.
Ladies: Please do not wear any makeup. If you are menstruating, tampons are not allowed while you are in surgery.
In the event there are changes to the surgery schedule, you must be available by phone prior to your report time.
Please check in with Admitting (use the Emergency entrance) two hours prior to your scheduled surgery time.
An admitting representative will help complete your registration and have you sign any appropriate forms. Payment of deductibles and co-pays (or pre-payment for non-insurance covered services) will be made at this time. After paying, please leave your money or credit cards with a family member.
The admitting representative will direct you to the Surgery department. You will check in with the nurse and family members will be directed to the Surgery/SICU waiting room. After you change into your gown and have a private interview with the nurse, an IV will be started. Family members will then be called to stay with you until surgery.
The surgeon and anesthesiologist will speak with you and your family prior to surgery. The operating room nurse will meet you and prepare you for the operating room. The surgeon can advise you how long the surgery will take.
In most cases, the surgeon will speak with the family after your surgery. For patient privacy, no visitors are allowed in the recovery room.
If you are going home after surgery, you must meet certain criteria (i.e. blood pressure, able to use the restroom, etc.) before leaving; this may take one to three hours. You will be given discharge instructions and prescriptions may be provided. Someone must drive you home and stay with you for the first 24 hours. If you will be hospitalized after surgery, you will be taken to your room once criteria is met (i.e. appropriate blood pressure, etc.) and the room is available. The recovery room nurse will notify family members when you are going to a room. Family members are welcome to accompany you to your room. We ask that family members remain outside the room while you are transferred into your bed and the nurse assesses you. We kindly ask that visitors follow our visiting hours and policies and to please have children under the age of 12 remain with another family member at home or in the public areas of the hospital (i.e. waiting rooms, lobby, cafeteria).
Additional guidelines: Once you are transferred to a nursing unit, the staff will assist you in getting up for the first time, as well as helping you with walking as soon as possible.
To prevent respiratory problems, use the incentive spirometer every hour while awake if it is ordered by your physician.
Depending upon your procedure, you may have a special diet. The staff will advise you of what and when you can eat and drink.
ReqUiReD inFORmatiOn FOR sURgeRY
Bring this with you on the day of surgery. Emergency Contact: Ride Home: Medications / Vitamins / Herbal Supplements you are currently taking:
*Place additional medications on separate sheet of paper. Medications:
What Medications are you allergic to?
What happens when you take this medication?
541-683-8034 541-485-5245 Shahram Rezaee D.M.D., PC. Laleh Rezaee D.M.D., PC. The benefits of a happy, healthy smile health. Please fill out this form are immeasurable! Our goal is to help completely. The better we communicate, you reach and maintain maximum oral the better we can care for you. About You ❑ Single ❑ Married ❑ Divorced ❑ Widowed ❑ Sep
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ReqUiReD inFORmatiOn FOR sURgeRY