Hospital Forms

Austin Surgical Hospital has forms that must be completed prior to receiving surgical services. The information obtained will be utilized to help hospital staff understand the patients' health history and personal information. The information on the form(s) is kept confidential and can be completed by the patient or by hospital staff. Completed forms can be returned via fax, mail, or in person prior to the scheduled Pre-Admission Testing appointment.

Forms

• Adult History Questionnaire [47.95 KB PDF]
  To expedite your visit to Austin Surgical Hospital, please print, fill out, and fax this form to 512-314-3867. Alternatively you may bring it in or have it handy during your phone interview.
• Patient Guide [2.06 MB PDF]
  This document outlines exactly what to expect on your visit to Austin Surgical Hospital, with resources valuable to the patient.
• Joint University Presentation [521.03 KB PDF]
  Presentation given to prospective joint patients as they consider Austin Surgical Hospital for their surgery. PDF format.
• Patient Registration Form [87.24 KB PDF]
  To expedite your visit to Austin Surgical Hospital please complete this form and bring it with you to the hospital.
• Imaging Patient Record [2.42 MB PDF]
  To expedite your visit to Austin Surgical Hospital please complete this form and bring it with you to the hospital.
• Magnetic Resonance Screening Form [2.24 MB PDF]
  To expedite your visit to Austin Surgical Hospital please complete this form and bring it with you to the hospital.
• Sleep Study Patient Packet [211.45 KB PDF]
  To expedite your visit to Austin Surgical Hospital please complete this form and bring it with you to the hospital.
• MRSA Shower Instructions [1.31 MB PDF]
  Please follow these shower instructions before your surgery to reduce the number of germs on your skin. Any drug store will carry chlorhexidine body wash designed to reduce the bacteria on your skin.
• Fall Prevention Instructions [922.07 KB PDF]
  Falls are the top cause of accidents in people over the age of 65. Falls are also the main cause of serious injuries and accidental deaths in older people. Review the attached document to learn how to prevent falls.
• MRSA Patient Education Form [82.13 KB PDF]
  What You Need to Know About Staph/MRSA Skin Infections.