Medical History & Nursing Agreement
Please use www.OneMedicalPassport.com to complete (fill-out) your medical history form as soon as possible. You will receive a phone call from an RN (2-5) days prior to your surgery and/or procedure date.
Please make sure we have a daytime phone number (Cell phone, if possible) where you can be reached.
Contact your family physician if you require lab work or an EKG.
Labs good for 30 days before surgery date. EKG good for 6 months before surgery date.
Note: All females ages 12-55 years with a uterus will have a pregnancy test day of surgery.
Please call 609-265-7800 the day before your procedure/surgery between the hours of 2:00 PM – 4:00 PM for your arrival time at the Memorial Ambulatory Surgery Center. Please call Friday if you are having surgery on Tuesday.
If you are taking blood thinners, aspirin, ibuprofen, motrin, advil, aleve, diet pills or herbal supplements, call your surgeon and/or physician for further instructions. Discontinue diet or herbal supplements two (2) weeks prior to surgery and/or procedure.
Do not eat or drink anything after midnight the night before your surgery, unless otherwise instructed by the pre-admission nurse.
On surgical and/or procedural day bring the following
Please take notice that the Facility bills under Virtua Health System’s insurance contracts and is considered in network with any contract Virtua Health System participates. If you have another carrier the facility may not be a participating provider with your insurance carrier and your upcoming procedure will be considered “out-of-network”. In either case you will be personally responsible for the co-payment, co-insurance, deductible, or other charges associated with your care for any services that are not covered by your insurance carrier. It is important that you contact your insurance company directly to obtain more information on your plan coverage and out-of-pocket costs
Our goal is to provide you with an excellent patient care experience.