Patient Forms

Hospital documents are to be completed and sent to the appropriate hospital. Ensure a surgery date is added. These must be received prior to surgery.

Southern Cross Brightside Hospital Bookings
	Agreement to Treatment	Southern Cross Brightside Hospital Bookings P.O. Box 26064 Epsom, Auckland 1344
	Patient Admission Form
	Patient Health Questionnaire

Ascot Hospital Bookings
	Patient Registration and Health History form	Ascot Hospital Bookings Private Bag Remuera, Auckland 1149

The Anaesthesia Assessment form is sent to the rooms and we will pass this on to your Anaesthetist.

Anaethesia Assessment Form
	Anaesthesia Assessment- Patient Questionnaire	Adam Dalgleish Orthosurg Ltd P.O. Box 74446 Greenlane Auckland 1546

You can also scan and email all forms back to admin@orthosurg.co.nz if you wish.

You will need the Adobe Reader to view and print these documents.