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Forms and Protocol for Surgery Scheduling

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This is a case request form that must be completed for all cases as of today, March 19, 2020. The form must be faxed in. We will no longer accept telephone surgery scheduling, and we are suspending, in the short term, electronic case requests. Cases will be reviewed for appropriateness according to an algorithm (attached). The Essential Procedure Review Team will review all cases according to the algorithm. Physicians will be notified if the team has questions about their case. All surgical blocks are being suspended effective today, and we will work to optimize surgeon time and provide efficient use of our operating rooms.

March 19, 2020
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