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Patient Forms

Click on the links below to download the forms you need before having minimally invasive spine surgery at Kishwaukee Hospital:

What to Bring to the Hospital

Personal Items

  • Toothbrush
  • Deodorant
  • Other personal hygiene items
  • Shorts
  • Shirts
  • Well-fitted slippers with non-slip soles
  • Flat shoes or tennis shoes
  • Glasses and hearing aids if you rely on them
  • Your CPAP machine if you have sleep apnea
  • Cell phone and charger
  • Adaptive equipment such as a walker or reachers (these may be brought to you after your surgery)

Personal Information

  • Your patient Guidebook with completed medication list
  • A copy of your advance directives if you have them
  • Your insurance card, driver's license or photo I.D.
  • Any co-payment required by your insurance company

Special Instructions Before Surgery

You will be given specific instructions from your surgeon regarding medications, skin care, and showering.

  • ONLY take the medication that you have been told to take, with a sip of water.
  • Please leave jewelry, valuables, and large amounts of money at home.
  • Makeup must be removed before your procedure.
  • Remove all rings and leave at home.
  • Nail polish must be removed.
  • Wear dentures and/or partials.

More Information

View and download our guidebook for more information on having orthopedic/spine surgery at Kishwaukee Hospital, including instructions for after surgery, information on pain management and avoiding infection, and a complete list of exercises that will help you recover.

Contact Us

Make an appointment with our Spine Care Coordinator to learn more about our patient-centered process for back surgery or to schedule a tour.

Dave Smith, Spine Care Coordinator
815.748.2968

Guidebooks

Available guidebooks for download

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