Surgical Services

Block release (PDF)

Downtime case request form (PDF)

Maximum surgical blood order schedule (PDF)

Record surgical procedure scheduling request (PDF)

Ordersets

Pediatric general surgery (PDF)

Miscellaneous patient care documents

Helen DeVos Children's Hospital map (PDF)

Helen DeVos Children's Hospital map (Spanish) (PDF)

Invasive or complex procedures (PDF)

Invasive or complex procedures (Spanish) (PDF)

Transfusion of blood or blood products (PDF)

Release from responsibility for patient refusal of blood and blood product transfusions (PDF)

Anesthesia consent (PDF)

Anesthesia consent (Spanish) (PDF)

Treatment and release of information general consent (PDF)

Treatment and release of information general consent (Spanish) (PDF)

Communication handbook (PDF)

Optime – In basket change request (PDF)

Orthopedic handbook (PDF)

Orthopedic handbook (Spanish) (PDF)

Surgical services patient handbook (PDF)

Surgical Optimization Center brochure (PDF)

Surgical Optimization Center brochure (Spanish) (PDF)

Bariatric orderset (PDF)

Cardiothoracic orderset (PDF)

General surgery orderset (PDF)

Genitourinary orderset (PDF)

Gynecologic oncology orderset (PDF)

Head and neck orderset (PDF)

Implantable intrathecal medication pump (PDF)

Lower gastrointestinal orderset (PDF)

Neurosurgery orderset (PDF)

Ophthalmology pre-scheduled surgery (PDF)

Orthopedic orderset (PDF)

Pediatric general surgery order (PDF)

Peripheral vascular orderset (PDF)

Plastic surgery pre-scheduled surgery (PDF)

Upper gastrointestinal orderset (PDF)

Urology gynecology orderset (PDF)

Fasting times policy (PDF)

Pre-admission anesthesia protocol (PDF)

Preoperative anesthesia orders (PDF)

Scheduling cases for surgery (PDF)

Amended boarding slip (PDF)

Block frequently asked questions (PDF)

Block release (PDF)

Block request/change/deletion (PDF)

Block appeal escalation (PDF)

Case booking appeal escalation (PDF)

Additional anesthesia services request

Dental procedures requiring hospital setting (PDF)

Pediatric orthopedics operative case classifications (PDF)

Scheduling request (PDF)

Standard work case booking appeal escalation (PDF)

Surgical Optimization Center patient criteria (PDF)

Surgical Optimization Center referral (PDF)

Ambulatory surgery guideline qualifications (PDF)

Anesthesia risk stratification (PDF)

Diabetes management pre-procedure (PDF)

Hard stops (PDF)

Hard stop appeal process tip sheet (PDF)

History and physical (PDF)

History/physical 24-hour update (PDF)

History/physical conditional (PDF)

History/physical pre-procedure/time of procedure (PDF)

Levels of surgery (PDF)

Pre-admission testing (PDF)

Request for history/physical outpatient, pediatric sedation team (PDF)