(844) 274-8497



Surgery Forms and Information


In order to facilitate the surgery scheduling process, St. Mary's Medical Center provides the following forms and information. Please click on the links below to open the documents. They can be printed for your use.

Anesthesia Pre-Operative Testing Guidelines 

Antibiotic Dosage Guidelines 

Dictation Instructions 

History and Physical - Complete Form

History and Physical - Short Form 

Ortho Equipment Request 

Planning for Your Surgical Procedure 

Surgery Scheduling Form