Mandatory Pre-Registration/Health History Questionnaire
In preparation for your upcoming procedure it is vital that we obtain your detailed medical history. One Medical Passport allows for an easy way to record all pertinent information required. This site is HIPAA compliant and confidential. Once complete the Center will be able to access this information. You may also print out a copy for your records.
Before beginning your Medical Passport be sure you have available
- Your heath insurance information
- The names, addresses and telephone numbers of your physicians
- A list of all medications you are taking, dosage and frequency
- A list of surgical procedures you have ever had and their approximate dates
- To begin your this process please click here
If you are unable to complete your medical history online please contact the Center by calling 301-263-0800. Your procedure is predicated on obtaining all necessary information well before your scheduled appointment