Health Forms

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.
• Patient Checklist (English or Spanish)
• Video: Preparing for Surgery at Ronald Reagan UCLA Medical Center | Preparing for Surgery at UCLA Mattel Children's Hospital
• Patient Guide: Ronald Reagan UCLA Medical Center | UCLA Mattel Children's Hospital

Make sure you have completed all the items that pertain to you.

For Patients at UCLA Medical Center, Santa Monica

• Important Information Regarding Your Surgery (English or Spanish)
  Please read this carefully and follow the instructions.
• Patient Checklist (English or Spanish)
• Video: Preparing for Surgery
• Patient Guide: UCLA Medical Center, Santa Monica
• Additional information for Orthopaedic and Spine Surgery patients

Make sure you have completed all the items that pertains to you.

Advance Healthcare Directive (AD)

What is an Advance Directive?