Patient Registration and Health History for the Mayfield Spine Surgery Center
What information do I need to be able to complete this form?
Before you start the process, please have the following information handy.
It’s critical that you list all medications you take and are prescribed, including those you may have stopped taking in preparation for your procedure. Even if you’re already a patient with us, please fill this section out completely.
Complete your health history form
Rest assured, this online form is easy and secure.
Mayfield Spine Surgery Center is observing the CDC’s recommended preventive actions to help prevent the spread of respiratory diseases, including COVID-19. Our number one priority is the safety of our patients and staff.
Your guide to outpatient surgery, physical medicine, and rehabilitation procedures
Find out what to expect before, during, and after your visit to Mayfield Spine Surgery Center.
Surgery and Pain