Anaesthesia Assessment Form (Elite Aftercare)

Anaesthesia Assessment Form (Elite Aftercare)

Anaesthesia Assessment Form for Elite Aftercare. Form Preview
  • Anaesthesia Assessment Form

  • Complete this form if you will be undergoing anaesthesia. Please read the anaesthetic booklet and answer all questions as accurately as possible. All information is sought to minimise your risk, and will be retained as part of your confidential clinical record.

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  • Health Questionnaire

  • 4. Do you suffer from, or have you ever suffered from, the following:

  • * (Pregnancy test should be done prior to the surgery when needed)

  • Thank you in advance for your cooperation.

  • Clear
  • Should be Empty:
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