Licking Memorial Health Systems - Measurably different...for your health
Patients & Visitors > Before You Arrive > Pre-Registration > Pre-Operative Registration
Pre-Operative Registration
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1. Patient Information
2. Current Medications
3. Allergies
4. Previous Operations
5. General Information
In order to plan for patient care, we ask that you complete the following form prior to the date of surgery. This information will be held in strict confidence. The following form will take approximately 20-25 minutes to complete. Please click the continue button below to get started.