Please complete all 6 pages of this Preoperative Health History Questionnaire. If you are unsure of an answer, check “not sure”. You can add details in the comments box. This information will help us better your pre-operative care. Based on your responses, you may require a Preadmission Clinic appointment or blood work.
After completion, scan and save as a .pdf file, attach and forward to preopforms@iwk.nshealth.ca. Please complete and email this form within 5 business days.