Physician Orders & Forms
In an effort to simplify the scheduling process, we have provided the most frequently used physician forms/orders for downloading. Please select the appropriate forms below.
For more details on scheduling procedures at Las Colinas Medical Center, click here
Quick links to the sections:
OB/Gyn Orders
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Surgery Orders
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Consent Forms
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Imaging Orders
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Outpatient Orders
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Additional Orders
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Pre-Admission Testing Orders
OB/Gyn Orders
- PAT Cesarean Delivery 8-12
- Cesarean Delivery 10-09
- GYN Post-Op Orders Inpatient 08-08
- GYN Post-Op Orders Day Surgery 1-11
- L&D Admission Orders 1-13
- OB - ED Orders 8-12
- Urology Post-Op Orders - Female Procedures 08-12
Consent Forms:
- L&D History & Physical Form 10-09
- Anesthesia Consent 1-12
- Blank Assistants During Surgery Consent 10-09
- Blank Blood Products Consent 10-09
- General Blank Disclosure 10-09
- General History and Physical Form Web Version
- Consent - Spine Operation Disclosure 02-12
- OB Pre-Registration Form 08-09
- Spanish OB Pre-Registration Form 08-09
- Vaginal Hysterectomy w/wo BSO Form 01-12
- Total Abdominal Hysterectomy Form 01-12
- Laparoscopic Hysterectomy Form 01-12
- Laparoscopic Repair or Inguinal or Ventral Hernia 1-12
Surgery Schedule Request Form
Surgery Orders
- Universal Pre-Op Orders (Includes PAT Orders) 1-13
- GI Pre-Op Orders 5-11
- Pre-Op Pain Medicine 8-10
- Peripheral Nerve Cath Orders 1-13
- Post-Op Pain Medicine 8-10
- Intra Post Endoscopy Orders 8-12
- General Surgery Post-Op Orders 7-10
- Outpatient Surgery Post-Op Orders 7-10
- Spine Surgery Post-Op Orders 2-11
Imaging
For the convenience of both our physicians and patients, we provide 3 locations for imaging services, 2 of which are outpatient facilities providing both easy access and cost effectiveness. After registration - Procedure will begin within 10 minutes (or less) of the scheduled appointment time.
In order to assist in selecting the correct location/service for your patient please review and choose the appropriate icon below:
We hope this simplifies the selection process for selection of services as provided by each location. Each order form is downloadable by choosing a location icon above. If you have any questions regarding the ordering of an exam, please call (972) 612-6565.
- Physical, Occupational and Speech Therapy Orders 5-12
- Cardiac Rehab Orders 12-08
- Pulmonary Rehab Reference 12-08
- Pulmonary Rehab Orders 12-08