Forms for Surgery

Please print and complete the following forms to bring with you on the day of your procedure. Please call 410-884-4500 to pre-register.

• Acknowledgement of Receipt of Notification of Privacy Practices
• Authorization for Release of Medical Records
• Pre-Anesthesia Form

En Espanol:

• Acuse de Recibo del Aviso de Practicas de Privacidad
• Autorizacion Para Hacer Entrega de la Informacion Medica
• Formulario Previo a Administracion de Anestesia

Advance Directives

An advance directive is a legal document that allows you to give specific instructions about your medical treatment if you become unable to communicate. The document can be tailored to meet your individual preferences and values and can include information about the types of treatment you want or do not want in certain situations.

• Advance Directive information from the Maryland Office of the Attorney General

For your information and review prior to admission

• Johns Hopkins Notice of Privacy Practices for Health Care Providers
• In Surgery Infection Control and Safety Precautions
• Patient Rights and Responsibilities
• Smoking Cessation
• SpeakUp Brochure
• An Introduction to Postoperative Pain Management

En Espanol:

• Aviso de practicas de privacidad para profesionales de la Salud
• Cirugia - Precauciones de Seguridad & Medidas de Control de Infecciones
• Hable! Ayude a Prevenir Errores en el Cuidado Recibido
• Dejar de Fumar Vale la Pena
• Introduccion al Control del Dolor Postoperatorio