- Clinical History
Thank you for choosing the Countryside Surgery Center for your upcoming surgery or procedure.
To start the pre-surgical assessment process, Countryside Surgery Center requests you complete your medical history online with One Medical Passport.
We recommend you enter your medical history online as soon as your surgery has been scheduled. Once you do this, our Pre-Surgical Assessment nurse will be able to access the information you entered online. This information will assist the nurse in organizing and documenting your complete medical history to prepare for your surgery.
Be sure to have the following information available before starting One Medical Passport:
- Your health insurance information.
- The names, addresses and phone numbers of your physicians.
- A list of all medications you are taking, their dosage and frequency.
- A list of surgical procedures you have ever had
- The name of the surgeon who will be performing your upcoming procedure
About One Medical Passport
Completing a One Medical Passport medical history online is easy. For most patients, filling out the entire questionnaire takes less than 30 minutes. Please fill out the questionnaire accurately, and be assured that all of your information is kept confidential and will be thoroughly reviewed by your medical team. At any time, you can quit filling out the questionnaire and come back and complete the unfinished portion at a more convenient time.
One Medical Passport is a website that allows you to enter your information at any time from anywhere. You can also print out a copy of your medical history after you create it online and keep it with you or with your other health care documents, as well as have access to it online anytime you need it or want to update it. You will be asked to create your own personal username & a password for future use when returning to this website to update or reuse your medical history information. This username & password will be for your unique individual use to further secure your medical information.
Information Security: One Medical Passport uses the highest grade of Internet security available: 128 bit encryption with SSL (secure socket layer) technology. Your information is stored on servers at a secure webhosting site and will only be released to your medical team.Your information is never released to anyone other than your medical team.