KNEE ARTHROSCOPY/ACL PACKET
Patient Name: ______________________________________________
Pre-Op Appt: (if applicable): ___________________________________
Your surgery will be scheduled at: ______________________________. The facility staff will contact you the night before
your surgery (anytime between 4:00 pm-7:00 pm), to inform you of your arrival time. You will enter the hospital through
the front entrance and inform the front desk that you are there for surgery with:
Dr. ______________________________________. Viera Hospital: 8745 N. Wickham Road, Viera, FL 32940 Tel: (321) 434-9400 Cape Canaveral Hospital: 701 W. Cocoa Beach Causeway, Cocoa Beach, FL 32931 Tel: (321) 799-7111 Melbourne Same Day Surgery: 1035 S. Apollo Blvd., Melbourne, FL 32901 Tel: (321) 434-7216 ANESTHESiA:
If you have any specific questions concerning the anesthesia used during your surgery or you want to verify that the
anesthesiologist used during the procedure is in network with your insurance, please contact Brevard Anesthesia directly
at (321) 723-4723 or via their website at www.basflorida.com, or Cape Canaveral Hospital Anesthesia at (321) 799-7111. FiNANCiAL:
Our office contacts your insurance company to obtain benefits and authorization for your surgery. You will receive a call
from our office regarding any financial obligations that must be met prior to your surgery (IE: co-pay, deductible or surgery
Some of the information below may or may not apply to you. Please review all of the information carefully. MEdiCAL CLEARANCE:
Medical clearance is required by your primary care physician (PCP) if you have a chronic lung condition such as emphysema,
bronchitis, COPD or use oxygen regularly. Please inform our office if you have any of the above. A clearance letter will be
provided to you and/or a copy will be faxed to your physician. Anesthesia requires that a signed copy of the clearance letter
be available at least 1 week prior to your surgery date. If anyone with a history of seizures may be required to obtain a note
Cardiac clearance is required if you are under the care of a cardiologist or if you have a heart condition such as angina,
heart failure or have had a recent heart attack. A clearance letter will be provided to you and/or a copy will be faxed to your
cardiologist. Please have your cardiologist office fax the clearance to (321) 434-9202. Anesthesia requires that a signed copy
of the clearance letter be available at least I week prior to your surgery date.
www.vieraorthopedics.com Office: 8725 N. Wickham Road | Suite 301 | Melbourne, FL 32940 | Phone: 321.434.9200 | Fax: 321.434.9202
If you have had ANY of the following tests, please have a copy faxed to our office at (321) 434-9202. Anesthesia requires that
a copy of these tests be available at least 1 week prior to your surgery date.
Stress test within the last 5 years Cardiac catheterization within the last 5 years Echocardiogram within the last 5 years Sleep study within the last 5 years PFT (pulmonary function test) within the last 5 years
If you are taking blood thinners for blood clots, cardiac stents, heart valve replacement, etc. Anesthesia requires that a
signed letter from your PCP or cardiologist, informing that it is ok for you to discontinue your blood thinning medication
approximately 5 -7 days prior to surgery, be available at least I week prior to your surgery date. You can have your physician
fax the letter to our office at (321) 434-9202. You will be provided with an order to have the required preop lab work and/
or EKG done prior to surgery. Anesthesia requires that the lab work be completed within 28 days of the surgery date at the
Viera Medical Plaza (located on the first floor of our building). It is important to confirm that the Health-First lab is in your
insurance network. You may be required to have your labs done elsewhere to avoid an out of network additional fee. Some
medications require specific blood work. Please inform our office if you are taking any type of water pill, heart pill, seizure
EKGs are good for 6 months prior to the surgery date. If you have had an EKG within the last 6 months, please inform our
office and have a copy of the EKG faxed to our office at (321) 434-9202.
Those patients who have had a prior history of blood clots in their legs or lungs will be prescribed blood thinner injections
or pills to prevent more clots after surgery. You will be provided with separate instructions and paperwork to arrange a no
charge teaching session with a clinical pharmacist to explain the process and eliminate any worries.
Please stop taking all OTC (over the counter) medications (EXCEPT Tylenol)(this includes Vitamins, Aleve, Advil, Ibuprofen, Motrin, Excedrin, Bayer) and all anti-inflammatories (Celebrex, Naproxin, Naprosyn, Mobic, Relafin, Voltaren, Cataflam) at
least 10 days prior to your surgery date. You will continue all prescribed medications (except those listed above) unless
otherwise advised by your physician(s) or the pre-op nursing staff.
Hospital pre-surgical nurses will call you within a few days of surgery to confirm medical problems, allergies and laboratory
values. They will answer your questions about what to wear, medications to continue or stop, etc. Additionally, you will be
contacted by the surgical facility the day prior to your procedure between 4 pm - 7 pm to advise you on your arrival time.
If you were given a brace in the office please remember to bring it to the hospital. Keep it clean and in the original packaging.
It will be brought into the operating room.
Remember to bring any x-ray films or disks that were not kept by our office personnel.
Please make sure to remove any nail polish from hands prior to surgery.
If you have any questions, please contact our office at 434-9200:x69223 for Dr. Greenspoon
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