Search In   For     
Surgery - Before and After
Clinical History
Financial Arrangements
Phone Directory
Maps and Directions
Quality Initiatives
Careers
Virtual Body
Cheercards ®
Aging and Health
Alternative Health
Sports and Fitness
Food and Nutrition
Men's Health
Mental Health
Kids' and Teens' Health
Medications
Travel and Health
Women's Health




   
Home
Help

Online Clinical History

You can now submit your clinical history online.

It will take approximately 10-20 minutes to complete the online clinical history form, depending on your medical history.

For privacy reasons, you will NOT be able to save your form to work on it later and if you leave your computer idle for more than 20 minutes, your form will not be saved. You will have to begin again. Please be sure you have enough time to complete the entire form before you begin.

Before you begin, be sure you have all of the items listed below on hand.

  • The name of your doctor who is admitting you to the facility
  • The date of your scheduled procedure
  • A short description of the procedure
  • The name of the person driving you home
  • The name of the person that will care for you after the procedure
  • The name and dosage of ALL of your medications
  • The dates and descriptions of past surgeries

To register, enter the date of your scheduled procedure below and then click "Start."

Date of procedure:

If you would prefer not to submit your clinical history online, please call the facility at 941-746-1121 for a telephone interview.

If you have any questions regarding your clinical history or the above procedures, please call us between 8 a.m. - 4:30 p.m., Monday thru Friday, at 941-746-1121. We look forward to serving you as our patient!



Gulf Coast Surgery Center
411 Second Street East
Bradenton,  FL  34208
Telephone: 941-746-1121
Fax: 941-746-7816
You May Also Visit Us At http://www.gulfcoastsurgery.com

Handwashing Awareness Month

The single most important thing you can do to keep from getting sick and to stop the spread of disease-causing germs is to wash your hands often. By frequently washing your hands, you wash away germs that you may have picked up from other people or from contaminated surfaces.

 
 
 
Send This Page To A Friend
Print This Page