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The following checklist describes the information we require from you before or during your
initial examination. Please be prepared with this information for your first visit. In some cases
you may be required to mail this information ahead of time. Any information you provide to
Orthopedic Spine & Sports and Penn Surgery Institute should be clearly marked with your
name, address, and phone number.
Information about your referring or primary physician:
- Name
- Address
- Phone Number
- Fax Number (if applicable)
- Email (if applicable)
Information about you:
- Name
- Birth date
- Address
- Phone Number
- Email (if applicable)
- Social Security Number
- Insurance Information - Please bring your insurance card with you
- Emergency Contact and Phone Number
- Questions for Your Doctor - Please prepare a list of specific questions (if any) that you would like to ask
Your complete Medical History and Records:
- Please bring a complete medication list with you when you come to the facility. We
need to know: name of each drug, how often you take it, dose, reason for taking, and the
time of last dose. Also include all vitamins, herbals, or over-the-counter pills or remedies.
This helps avoid confusion over dosages and names of your current medical program. It
is highly encouraged that you bring your original medication containers.
- Bring the discharge summaries from any recent hospital stays (within the past 3 to 5
years).
- Make a list of any devices (such as a pacemaker) and the type and settings that have
been prescribed for you, if known.
- If you have had any diagnostic tests or procedures prior to your visit with us, please
obtain the actual tests (films or tracings) and reports from your outside doctor. Bring this
information with you, or mail it ahead of time via overnight mail or express mail to
Orthopedic Spine & Sports and Penn Surgery Institute.
Other important information to prepare for your visit:
You will receive an appointment schedule in the mail prior to your visit. If your visit is
scheduled within two days of your appointment, you will receive your written schedule
when you arrive.
You are required to bring a family member or friend on the day of your procedure or surgery. This person must remain in the facility during your procedure and will drive you home. This person should be present to assist you during your recovery at home for the first 24 hours.
Take all of your medications as prescribed, unless you have been given other
instructions. If you have diabetes, ask for specific diet and medication instructions.
For driving directions, click here
Unless otherwise stated, please report to the front desk on the 2nd floor, Orthopedic
Spine & Sports and Penn Surgery Institute, to start your appointment. This is located
directly across from the Lancaster General Hospital's North Duke Street entrance.
Please have all how appointment and insurance information readily available for the
receptionist.
If this is your first visit, please be sure to arrive ahead of your scheduled time so that
you can fill out all the necessary forms. Otherwise, this may delay your appointment as
well as other patients.
If You Have Any Questions or Need to Reschedule Your Appointment, please contact
the our office as soon as possible (717) 299-3524.
Patient Safety Tips
Your safety is top priority...
You are an important member of your care team. We ask that you be an active participant in
your safety. When you need more information on your condition, or don't understand something
about your care, please tell us. If you don't feel comfortable discussing this with your care
provider, we have a patient advocate you can contact to discuss your concerns.
There are also specific steps you can take to stay safer during your stay, including
preventing falls, and encouraging those around you to wash hands carefully. By partnering with
you, our nurses, doctors and other caregivers can provide medical excellence every day.
Checklist for safety (7 points):
#1 List allergies
Please list any allergies. This information is very important because your current medication use
can impact treatment decisions.
#2 Wash hands
Your mother was right! Hand washing plays an important role in preventing infections in the
hospital. If you don't see this happening, feel free to speak up and ask your caregivers and
visitors to wash their hands, or use the hand hygiene gel.
#3 Ask questions
If you are uncertain about any procedure or medication, please ask for clarification. If you still
are unclear, ask again. We want you and your family to fully understand your pain and/or illness
as well as your procedure and how to best manage your health care long term.
#4 Expect questions
You will likely answer the same questions repeatedly, but it is important for caregivers to ask
you identifying information, like your name and date of birth before medications are
administered and procedures are conducted. Your safety is the most important thing to us, so
ensuring we are doing the right thing for the right patient is a top priority.
#5 Prevent additional injury to yourself
When you are in the center and receiving treatments and/or medicine, you may not be as
steady as you normally would be. Be sure to follow your care providers' instructions to prevent
unnecessary falls. This may include asking for help before you get up from your seat or
examining table or even requesting the service of a wheel chair. The goal is to prevent
unnecessary falls that could be very serious and further complicate your condition.
#6 Share history
We want to know your health history before we treat and/or prescribe anything. It is important to
share any past or current health problems; medication, latex or food allergies, and any past
surgeries.
#7 Going home
Taking care of yourself after you leave the Orthopedic Spine & Sports and Penn Surgery
Institute is a crucial part of your recovery. Ask your caregiver what to expect and how to take
good care of yourself after discharge, including when and how to take any medication. A trusted
friend or family member can help you process this information.
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