Written instructions provided to patients after a surgical procedure.
Purpose: These instructions are provided to guide you through a safe and smooth recovery following your recent surgical procedure. Please read carefully and follow all directions. If you have questions, contact your healthcare provider.
Patient Name: {name}
Date of Surgery: {surgeryDate}
Procedure Performed: {procedureName}
Contact | Role | Phone Number |
---|---|---|
{#contacts}{contactName} | {role} | {phoneNumber}{/contacts} |
Wound Care:
{woundCareInstructions}
Medications:
Take your medications exactly as prescribed.
{#medications}
{/medications}
Activity Restrictions:
{activityRestrictions}
{#appointments}
{/appointments}
Contact your healthcare provider immediately if you experience any of the following:
{#warningSigns}
{/warningSigns}
{additionalNotes}
{#hasInsurance}
Insurance Provider: {insuranceProvider}
Policy Number: {policyNumber}
{/hasInsurance}
{^hasInsurance}
Note: This patient does not have active insurance on file.
{/hasInsurance}
I, {name}, confirm that I have read and understood the postoperative instructions provided by my healthcare team.
Patient Signature: _____________________________
Date: {currentDate}
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