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Patient Forms
 
 

Download and complete the appropriate Health History Form

........................................................................................................................

We recommend you fax the completed form to 373-6133 prior to your phone interview with our pre-op nurse.
This will allow our pre-op nurse to review your form prior to calling you.

If you prefer, the form may be dropped off in advance at the Surgical Servces desk on the hospital's main corridor.

 
 
For more information, call us at 373-6138.
 
Pediatric Surgery
 

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Mid Coast Hospital - For a Lifetime of Caring

123 Medical Center Drive, Brunswick, Maine 04011
Copyright © 2014. Mid Coast Hospital. All rights reserved.

 
Accredited by The Joint Commission. Recognized as
a Magnet™ Hospital for exceptional nursing and patient care by the American Nurses Credentialing Center.
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