Customise your Pre-Anaesthetic Assessment Form – Top Changes

While the Standard pre-anaesthetic assessment form (demo here) suits most Anaesthetists, it doesn’t suit everyone. In our Premium Plan, we can customise each question, confirmation message and even email notification(s) for you. You have unlimited levels of depth so follow-up questions can be based on previous responses. We also handle all the setup and changes for you, and it’s all included in your flat monthly fee.

Below are some popular assessment form changes our Premium members have made. From Highlighting important questions or just the YES Answers and Flagging Issues. For paediatric patients, we can Calculate Age in Months for infants or even ask about their First 12 month health, Recent Sickness, or Other Common Issues.

If you have patients on specific medications we can show Medication Warnings during the form or even in the confirmation message. As well as a variety of other questions such as Recent Blood Tests, Exercise Ability and many Other conditions.

Alternatively, you might have a billing service that contacts patients for IFC – well we can automatically Email your Billing Service (saving you so much time!!) or Display Payment Details and fee advice for specific patients.

It is also possible to add Risk / Consent features, Do Not Drive / Pick up Warnings and even send the patient procedure specific information in their Confirmation Message (Send specific procedure documents).

The options are endless!

Below are the list of top changes, however to see the full list of customisations please visit our full Premium Changes page here.

1. Highlight Questions (on your notification)

Highlight Anaesthetist Questions - pre-anaesthetic assessment form

We can highlight important anaesthetic questions in whatever colour you would like so they stand out.

2. Highlight YES Answers (on your notification)

Highlight Anaesthetist Yes Answers - pre-anaesthetic assessment form

Instead of highlighting questions like above to make them stand out, you may only be interested in finding out if the answer is eg. “Yes”. The “Yes” answers of specific questions can be changed to another colour, such as red, so they are more noticeable.
CREDIT – Dr Callum Gilchrist

3. Flag Issues (on your notification)

pre-anaesthetic assessment form heading

pre-anaesthetic assessment form warnings BMI

pre-anaesthetic assessment form phone number

We can include any information you would like highlighted at the top of your email, such as if they / relatives have had any problems with anaesthesia or if the patient’s BMI is greater than 30. To make it easier for you to call patient’s, we can also include the patient’s telephone number at the top of the email.
CREDIT – Dr Lynda Allchurch (Problems with Anaesthesia) & Dr Nicola Doogan (BMI) & another member (Phone)

4. Infant – Calculate Age in Months

Child pre-anaesthetic assessment form age calculation

This form already calculates the patient’s age in years. For patients under a specified age, we can also calculate the age in months.
CREDIT – Dr Callum Gilchrist

5. Child Recent Sickness (variations)

Child Sick - pre-anaesthetic assessment form

Child cough on pre-anaesthetic assessment form

Ask other paediatric specific anaesthetic questions if the age is less than 16.
CREDIT – Dr Nicola Doogan (Significant RTI) & Dr Callum Gilchrist (Cough or Cold)

6. Child – First 12 months

Child NICU - pre-anaesthetic assessment form

Customise your pre-anaesthetic assessment questions for children

7. Child – Other Common Issues

anxious child on pre-anaesthetic assessment form

pre-anaesthetic assessment form ask swallow tablets

pre-anaesthetic assessment form teeth

Ask about other issues so the Anaesthetist has notice to give assurance to the parent if the patient (a child under 16) is anxious about the procedure etc.
CREDIT – Dr Nicola Doogan

8. Medication Warnings

Cease Medications - pre-anaesthetic assessment form

Cough syrup  - pre-anaesthetic assessment form

Twice show patient's medications list in anaesthetic assessment form

Email pre-anaesthetic assessment form medication warning

If specific medications (eg. Ozempic) are entered in the medication box, show a warning to the patient + also include a warning on a patient’s confirmation message and email.
CREDIT – Dr Chris McMahon

9. Recent Blood Tests

Recent Blood Test - Preoperative Anaesthetic Assessment

Ask patients if they have had a recent blood test, or only ask those that meet your requirements (eg. are on medications, have selected yes to certain health problems).
CREDIT – Dr Chris McMahon

10. Exercise Ability

Exercise - pre-anaesthetic assessment form

Ask the physical activity level of patient and if an activity is selected a box can also appear advising them not to exercise the morning of the procedure
CREDIT – Dr Chris McMahon

11. Other conditions

open mouth intubate question - pre-anaesthetic assessment form

Snore - pre-anaesthetic assessment form

Arthritis - pre-anaesthetic assessment form

chronic pain pre-anaesthetic assessment form

HIV pre-anaesthetic assessment form

Extend your pre-anaesthetic questions based on your common patient type
CREDIT – Dr Anna Pedersen (snore) & Dr Callum Gilchrist (split arthritis) & Dr Josephine Maria (chronic pain) & Dr Chris McMahon (viral infections) & another member (open mouth)

12. IFC Automated (Email your Billing Service)

anaesthetic billing service notifications

If you have a billing company who provides quotes to patients, we can create a notification to automatically go to your billing service with the patient’s basic (no medical data) details.
CREDIT – Dr Brenton Coats

13. Display Payment Details

anaesthetic billing confirmation

pre-anaesthetic assessment form showing anaesthetic service contact details

When the patient is asked if they would like a quote, if they select yes and also Direct Deposit as the payment method, we can include your payment details underneath and/or on the confirmation page and/or in the confirmation email they receive
CREDIT – Dr Muhammad Essop (email) & Dr Chris McMahon (billing service contact details)

14. IFC + Debt Collection Fees

Debt collection anaesthetist fees on Preoperative Assessment form

Ask patients to confirm they accept and are aware there will be a fee from their Anaesthetist and potentially collection / legal costs.

15. Collect + Do Not Drive Warnings

pre-anaesthetic assessment form asking patient drive

pre-anaesthetic assessment form - warn patient they MUST have a responsible adult to collect them from hospital

Pre-Op Health Questionnaire anaesthetist patient drive

Confirm patients have someone to pick them up and stay with them for 24 hours after their anaesthetic, and get them to confirm they won’t drive etc, or show them a warning if they don’t.
CREDIT – Dr Chris McMahon & Dr Josephine Maria & another member

Risks of Anaesthetic - pre-anaesthetic assessment form

Multiple options available – see

17. Confirmation Message (Send Documents)

pre-anaesthetic assessment form - safety surgery documents

pre-anaesthetic assessment form - safety surgery documents 2

We can completely customise the confirmation messages patients are shown when their form is submitted, based on the procedure or surgeon mentioned.
A list of information sheets / risk documents can be found at
CREDIT – Dr Josephine Maria & Dr Nicola Doogan & other members

How to upgrade

If you’re an existing Standard member and would like upgrade to the Premium plan so we can customise your pre-anaesthetic assessment form, please email us or visit our Upgrade Page here.

How to make a change

If you’re already a Premium member and would like to make a change to your pre-anaesthetic assessment form, please reply to one of our emails or fill in the request form at the bottom of our Full Premium Changes page here.

Joining Anaesthetic Group

If you’re looking to join us, read more about joining us and pricing at or please sign up below. You could start receiving pre-anaesthetic assessment forms today!

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