Scheduling Surgical Procedures

We provide forms and information to help you schedule patients for surgical procedures. Click on the links below to open the forms. They can be printed for your use or given to patients.

How to Schedule a Surgery or Procedure (instructions for using the forms below)

  1. Surgery Scheduling Form
  2. Surgery Scheduling Change Form
  3. Surgery Scheduling Cancellation Form
  4. Surgery Legal Representative
  5. Elective Surgery modified MeNTS Scoring Tool

For related information, please view our Pre-Hospital Information page.

COVID-19 VACCINE: We are providing limited community vaccination in partnership with Pasadena Public Health. Please do not call, we cannot schedule vaccine appointments. Find resources for vaccination here.   >> VACCINE INFO
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