In an effort to decrease pre-operative delays and improve patient care, Perioperative Services at Memorial Medical Center has developed a new standardized history and physical form and scheduling physician order form. Please fax completed forms to the pre-admission planning department at least 72 hours prior to the patient’s surgical procedure. For questions about these forms and additional pre-operative questions, please contact the Pre-Admission Planning office at 217-788-3958.
Preoperative Surgical History and Physical Form
Surgery Scheduling Physician Order Form