Hospital Affiliation

North Florida Regional Medical Center

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Schedulers

Schedulers, please fill out a copy of our Surgery Reservation Form and FAX it to us at 352-333-4564 or call our OR desk at 352-333-4562.

Also, please have your patients fill out a copy of the following forms which they should bring with them to their pre-operative appointment:

Pre-operative Acknowledgement Form

Welcome Form

Adult Anesthesia Questionnaire (For patients age 18 and over)

OR

Pediatric Anesthesia Questionnaire (For patients age 0 - 17)

Thanks from the Pavilion staff for all that you do to make our patients' surgical experience a positive one!