Wakefield
Freephone 0800 925 334
Forms & brochures

Having surgery is an important decision for you and that is why we require you to complete a number of forms and ask that you read the brochures provided. Here is a guide to our forms and brochures.

Pre-admission forms

1. Admission form

The Admission Form contains personal and payment information.

Download > Open a pdf (56kb)

2. Consent form

The Consent form relates to your medical diagnosis and details of your treatment which will be provided to you. Please fill in the personal details only. The consent to anaesthesia and treatment must be completed in consultation with your specialist.

Download > Open a pdf (55kb)

3. Health Questionnaire Form

The Health Questionnaire / Nursing Assessment Form provides us with the important details about your medical history.

Download > Open a pdf (81kb)

Important pre-admission information booklet

We recommend you read this booklet and the anaesthetic information pamphlet which you will find inside the back cover of it.

Brochures

Publications available on request

  • Pre-admission Information Booklet
  • Surgical Wounds (caring for your wound at home)
  • Methicillin Resistant Staphylococcus Aureus (MRSA)
  • Extended Spectrum Beta Lactamase (ESBL)
  • Patient Controlled Analgesia (PCA)
  • Epidural Pain Relief
  • Patient Questionnaire view.pdf
  • Complaints view pdf
  • Allergies, Sensitivities and Side Effects

To request one of these publications, please call us or complete the following:

 

Brochure enquiry form

Required *

 

 
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