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Paper Questionnaire

Press the button above to download a paper version of the Anaesthetic Pre-Operative Questionnaire.

You can print it, or you can fill it out on the computer with a program such as Adobe Acrobat reader.


When Finished, Either post it to:

Capital Health Administration
PO BOX 5125
Garran ACT 2605

Or fax it to:

fax: (02) 6169 3115

Or upload a photo or scan of your completed form here:

Or email it here:

pre-op@drrosshanrahan.com

Some medications such as blood thinners or diabetic medications may need to stopped several days before your surgery.

If your posted completed form potentially may not arrive with more than a week to go before your surgery please check if you are taking any of the below medications which may need to be withheld for longer periods.

If you are taking any of these and your questionnaire will arrive within a week of surgery, let us know using the contact form so we can make sure these medications are stopped in time.