Pre-Admission Testing Questionnaire

3 Easy Steps to determine if Pre-Admission Testing is required:

  • Download the Pre-Admission Testing Questionnaire at the bottom of this page.
  • Have your patients fill out the questionnaire.
  • Fax the completed questionnaire with your booking form to 866.567.3772

Our Medical Director will review the questionnaire within 24 hours. Our nursing staff will contact your patients if our Medical Director requires additional information. 

By allowing us to make the decisions, we can save time for you and your patient, and create an easier and less stressful peri-operative experience.

Should you have any questions, please feel free to contact our Patient Admissions Department at 212.254.3570 Option #3 or MedicalClearances@GramercySurgery.com.

Click on Form to download