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  • Pre-Anesthesia Questionnaire

Pre-Anesthesia Questionnaire

The Pre-Anesthesia Questionnaire is used to help prepare you for the anesthesia process and assists in the development of your anesthesia care plan.

Please print and fill out the PDF below as accurately and completely as possible.

  • Pre-Anesthesia Questionnaire

 

 

In This Section: Patients
  • All About Anesthesia
    • Before Anesthesia
    • After Anesthesia
    • Anesthetic Awareness
      • Anesthetic Awareness Fact Sheet
    • Anesthesia Options for Labor and Delivery
    • Questions You Should Ask
  • The Parent's Role
    • Is Your Child at Risk from Sleep-Disordered Breathing?
    • Sweet Dreams at the Hospital Coloring and Activity Book
  • Be Healthy: Stop Smoking
  • Herbal Products and Your Anesthesia
  • Time to Talk about CAM
  • AANA Warns Viagra Users of Potential Risks During Surgery
  • Anesthesia Risks of Tattoos and Pierced Tongues: More Than Skin Deep
  • Holiday Surgery Tips
  • MRI: What You Need to Know
  • Office-Based Anesthesia
  • Pre-Anesthesia Questionnaire
  • Does Anesthesia Affect a New Mom’s Ability to Breastfeed?
  • Opioid Addiction Help Fact Sheet

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  • Auto, Home and More

Patients

  • All About Anesthesia
    • Before Anesthesia
    • After Anesthesia
    • Anesthetic Awareness
      • Anesthetic Awareness Fact Sheet
    • Anesthesia Options for Labor and Delivery
    • Questions You Should Ask
  • The Parent's Role
    • Is Your Child at Risk from Sleep-Disordered Breathing?
    • Sweet Dreams at the Hospital Coloring and Activity Book
  • Be Healthy: Stop Smoking
  • Herbal Products and Your Anesthesia
  • Time to Talk about CAM
  • AANA Warns Viagra Users of Potential Risks During Surgery
  • Anesthesia Risks of Tattoos and Pierced Tongues: More Than Skin Deep
  • Holiday Surgery Tips
  • MRI: What You Need to Know
  • Office-Based Anesthesia
  • Pre-Anesthesia Questionnaire
  • Does Anesthesia Affect a New Mom’s Ability to Breastfeed?
  • Opioid Addiction Help Fact Sheet

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