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Lichtenstein Amid Hernia Clinic at UCLA


Patient Forms

Forms and Instructions prior to your surgery

We want to make sure the day of your surgery goes as smoothly as possible. One way you can help is by coming prepared. Please be sure to follow the instructions given to you by your surgeon. In addition, please review and fill out the attached documents and bring them with you the day of your appointment.

  • Important Information Regarding Your Surgery (English or Spanish)
    Please read this carefully and follow the instructions.
  • Fill out and bring with you the attached form: Surgery Intake Form
  • Patient Checklist (English or Spanish)
    Make sure you have completed all the items that pertains to you.

Additional Forms and Information


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