Surgical Checklist Outpatient

Thank you for choosing to schedule surgery with Dr. Benjamin G Domb. We are excited to be involved in your surgical experience. In preparation for your surgery, we would like to inform you of all the necessary steps to be completed prior to your procedure.

Dr. Domb’s surgery scheduler will contact you to set a date and location.

If you do not hear from her within 2-3 days, please call (630) 920-2323.

Surgical Checklist

Please have all items completed within 30 days of your surgery and prior to your preoperative appointment.

Letter for medical clearance from your primary care physician
Letter for medical clearance from specialist if necessary (e.g. cardiologist)
Preoperative lab tests
- Blood Work
- EKG (if requested or over 40 years of age)
- Chest Xray (if requested or over 40 years of age)
- Additional testing if necessary or recommended by your Medical Doctors
Discontinue Anti-inflammatories 7-10 days before surgery
Discontinue Birth Control 1 month before surgery
If on anticoagulation/blood thinners, immunomodulators, supplements
- Obtain preoperative plan for medication from your primary care physician
Fill out your Pre-op Surgical Questionnaire Online. (ONLY for Hip Surgery)
You will receive and email with a personalized link to your questionnaire. This will help us track outcomes to provide quality care for our patients.