Orthopedic Clinic Preoperative Checklist
Total Knee Replacement
at The American Center
Your surgery is scheduled on: ___________________________________
Your Orthopedic Pre-Surgical Visits are scheduled for: __________________
Orthopedic Clinic Preoperative Check List
______ Meet with a Physician Assistant.
______ Patient Education about total joint replacement surgery - you will be
______ Joint 101 class (the Orthopedic staff will tell you where the room is for this class)
______ Speak with a Social Worker (this may be done prior to your clinic visit).
______ Make a post-op appointment.
Please come for your visits at your scheduled time. The visits may take 1-3 hours. Feel free to
eat before you come. Also, please take your normal medicines.
Please read your Patient’s Guide to Total Knee Replacement booklet to help you prepare for
your clinic visits. Please write down any questions you have and bring them with your booklet
to your clinic visits.
If you can’t keep an appointment, please call the Orthopedic Clinic at (608) 263-7540.
Things to Bring with you:
Your insurance information
Your HMO referral, if needed
A list of your medicines, including
name, dose, frequency and any herbs and
Pre-operative folder information
A copy of your POA, if you have one
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©6/2016. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7789.