Surgery Intake Forms
Every surgery intake form a surgical practice uses, explained: what each one asks and why.
From general surgery and pre-anesthesia forms to plastic, vascular, bariatric and transplant surgery forms. Pick a form to see its questions.
Surgery intake forms by area
Forms grouped by the area of surgery that uses them. Every practice words its own forms differently; each page shows what a typical form asks.
- General surgery 12
- Pre-op and post-op 4
- Plastic surgery 8
- Breast surgery 9
- Body contouring 4
- Facial plastic surgery 6
- Non-surgical aesthetics 11
- Weight loss surgery 4
- Vascular surgery 4
- Reconstructive and hand 3
- Heart, chest and brain 4
- Transplant surgery 2
General surgery
12 forms- Anti-reflux surgery evaluation questionnaire
- Breast surgery new patient form
- Colorectal surgery new patient form
- Endocrine surgery patient intake form
- General surgery new patient forms
- Hemorrhoid symptom questionnaire
- Hernia surgery intake questionnaire
- IBD surgery consultation questionnaire
- Parathyroid surgery new patient form
- Pediatric surgery new patient form
- Surgical oncology new patient form
- Thyroid surgery new patient form
Pre-op and post-op
4 formsPlastic surgery
8 formsBreast surgery
9 forms- Breast augmentation consultation questionnaire
- Breast implant illness questionnaire
- Breast implant removal consultation questionnaire
- Breast implant revision consultation questionnaire
- Breast reconstruction consultation questionnaire
- Breast reduction patient questionnaire
- Breast surgery consultation form
- Gynecomastia consultation form
- Post explant questionnaire
Body contouring
4 formsFacial plastic surgery
6 formsNon-surgical aesthetics
11 forms- Body sculpting consultation form
- Botox consent form
- Botox consultation form
- Chemical peel consultation form
- Dermal filler consultation form
- Hair loss evaluation form
- Hair transplant intake form
- Laser hair removal intake form
- Med spa new patient intake form
- Men's aesthetic consultation form
- Microneedling consultation form
Weight loss surgery
4 formsVascular surgery
4 formsReconstructive and hand
3 formsHeart, chest and brain
4 formsTransplant surgery
2 formsSurgery intake forms: FAQ
What intake forms does a surgical practice use?
Most start with a new patient form and a medical history, then add forms for the area they treat. That can be a hernia or reflux questionnaire, a plastic surgery consultation form, a vascular questionnaire or a bariatric evaluation. Pre-anesthesia and post-op forms are common across all areas.
Is a surgery intake form the same as a pre-anesthesia questionnaire?
No. The intake form covers the reason for the visit, symptoms, history and goals. The pre-anesthesia questionnaire focuses on what the anesthesia team needs: past anesthesia, airway and sleep apnea, heart and lung health, medicines and allergies.
Why do surgery forms ask about GLP-1 medicines?
GLP-1 medicines used for diabetes and weight loss slow stomach emptying, which matters for anesthesia. Surgical and anesthesia societies have published guidance on these drugs before elective surgery, so forms ask which medicine, the dose and when it was last taken.
How are plastic surgery forms different from general surgery forms?
Plastic and cosmetic forms ask more about goals and expectations, past cosmetic procedures, smoking and nicotine use, and consent to photos. General surgery forms focus on symptoms, the condition being treated and fitness for surgery.
How does AI Doctor help a surgical practice?
AI Doctor, a real-time AI healthcare assistant avatar, asks the intake questions as a conversation, in the patient's own language. It collects the answers for the surgical team to review before the consultation or procedure.
Which form should a new surgical practice start with?
Start with a new patient form and a medical history form that fit your main procedures. Then add a pre-anesthesia questionnaire and a post-op follow-up form, and area forms as your service list grows.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.