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Instructions prior to your surgery
We would like to ensure that your experience on the day of surgery is a positive one. You can help by preparing in advance. Please be sure to follow the instructions given to you by your surgeon. In addition, please review and fill out the attached documents and bring them with you the day of your appointment. Please select the documents below according to the hospital where you are scheduled to have surgery.
To view these forms, Adobe Acrobat Reader is required. 
For Patients at Ronald Reagan UCLA Medical Center
- Important Information Regarding Your Surgery (English or Spanish)
Please read this carefully and follow the instructions. - Fill out and bring with you the two attached forms:
- Admission Medication History Form (English or Spanish)
- Health History
- Patient Checklist (English or Spanish)
- Video: Preparing for Surgery at Ronald Reagan UCLA Medical Center | Preparing for Surgery at Mattel Children's Hospital UCLA
- Patient Guide: Ronald Reagan UCLA Medical Center | Mattel Children's Hospital UCLA
Make sure you have completed all the items that pertain to you.
For Patients at Santa Monica-UCLA Medical Center and Orthopaedic Hospital
- Important Information Regarding Your Surgery (English or Spanish)
Please read this carefully and follow the instructions. - Fill out and bring with you the attached form:
- Patient Checklist (English or Spanish)
- Video: Preparing for Surgery
- Patient Guide: Santa Monica-UCLA Medical Center and Orthopaedic Hospital
- Additional information for Orthopaedic and Spine Surgery patients
Make sure you have completed all the items that pertains to you.
Advance Healthcare Directive (AD)
Advance Healthcare Directive Forms are available on our CHEC website. The forms are available in English, Spanish and Chinese.
