Patient Forms

Advanced Surgical Institute is in the process of establishing a relationship with One Medical Passport which is an online registration service.

When we go live with the service you will be able to fill out your personal history in a secure manner on a secure site.

Until we go live, you will be given the necessary forms at your physician’s office.

Online Medical History

To start the pre-surgical assessment process, Advanced Surgical Institute requests that you fill out your medical history online with One Medical Passport. We recommend that you enter your medical history online as soon as your surgery has been scheduled. Once you do this, our Pre-Surgical Assessment nurse will be able to access the information you entered online. This information will assist the nurse in organizing and documenting your complete medical history to prepare for your surgery.

Be sure to have the following information available before starting One Medical Passport:

  • Your health insurance information.
  • The names, addresses and phone numbers of your physicians.
  • A list of all medications you are taking, their dosage and frequency.
  • A list of surgical procedures you have ever had and their approximate dates.
  • The name of the surgeon who will be performing your upcoming procedure.