formisoft

Pre-Operative Assessment Form

Asks about do you have any allergies to medications, current medications, and do you have a history of any previous surgeries. Built for pre-admission testing for scheduled inpatient and outpatient surgeries.

Questions
7
Page
1
Time
about 2 min

Includes

  • E-signature
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Your practice

Live preview. Tap through it like a patient.

Who it is for

  • Pre-admission testing for scheduled inpatient and outpatient surgeries
  • Anesthesia risk stratification and ASA classification documentation
  • Surgical clearance coordination between primary care and surgical teams
  • Ensuring compliance with pre-operative fasting and medication hold protocols

What's inside

Before you publish: Clinical review required: this worksheet does not calculate scores, diagnose, or recommend treatment. Confirm the questions and response options against your approved assessment protocol before use.

  1. Full NameText · Required
  2. Date of BirthDate · Required
  3. Do you have any allergies to medications?Long Text · Required
  4. Have you experienced any of the following in the past 6 months?Checkbox · 5 choices · Required
  5. Current MedicationsLong Text · Required
  6. Do you have a history of any previous surgeries?Long Text
  7. SignatureE-Signature · Required

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the Pre-Operative Assessment Form, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

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Questions

Responses are encrypted, only your team can see them, and a BAA is included.

Yes. You can add, remove, reorder, or reword any of the 7 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the Pre-Operative Assessment Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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