South Brooklyn Health form
For treatment at South Brooklyn Health, 2601 Ocean Pkwy, Brooklyn.
Download form (PDF) →Patient forms
Forms for treatment day
Complete the form for your facility with your pediatrician within 30 days of the appointment, and bring it on treatment day.
EMU Surgery Center form
For treatment at EMU Health, 8340 Woodhaven Blvd, Queens.
Download form (PDF) →Treating at Queens Surgical Center?
Call us at (917) 979-6579 and we'll send the right paperwork.
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How to complete your pre-op form
- Download the form for the facility where your child is scheduled.
- Book a visit with your child's pediatrician within 30 days of the treatment date.
- Ask the pediatrician to complete and sign the history and physical section.
- Bring the completed form on treatment day, or send it to us ahead of time at OR@littlegrins.org.
Without a completed form, the facility may need to reschedule treatment. If you're not sure which form you need, call us at (917) 979-6579. Review the fasting rules and what to bring in our before and after surgery guide.