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		<table  border="0" cellspacing="0" cellpadding="0">	<tr class="navbarnum1">		<td class="navbarnum1" valign="top" align="left" title=""><a href="http://www.directory.ucla.edu"  target="_blank" class="navbarnum1">Directory</a></td>		<td class="navbarnum1" valign="top" align="left" title=""><img src='images/topnav_btwn.gif' alt=""></td>		<td class="navbarnum1" valign="top" align="left" title=""><a href="body.cfm?id=289"  class="navbarnum1">Maps</a></td>		<td class="navbarnum1" valign="top" align="left" title=""><img src='images/topnav_btwn.gif' alt=""></td>		<td class="navbarnum1" valign="top" align="left" title=""><a href="body.cfm?id=173"  class="navbarnum1">Calendar</a></td>		<td class="navbarnum1" valign="top" align="left" title=""><img src='images/topnav_btwn.gif' alt=""></td>		<td class="navbarnum1" valign="top" align="left" title=""><a href="body.cfm?id=46"  class="navbarnum1">Newsroom</a></td>		<td class="navbarnum1" valign="top" align="left" title=""><img src='images/topnav_btwn.gif' alt=""></td>		<td class="navbarnum1" valign="top" align="left" title=""><a href="body.cfm?id=927"  class="navbarnum1">Mobile</a></td>	</tr></table>
	
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					<td width="100%" align="right">
						<table width="100%" border="0" cellpadding="0" cellspacing="0">
							<tr>
								<td width="100%" height="28" align="right" style="padding-right:20px; vertical-align:middle;">
									
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		<table  border="0" cellspacing="0" cellpadding="0">	<tr class="navbarnum2">		<td class="navbarnum2" valign="top" align="left" title=""><a href="homepage_giving.cfm?id=7"  class="navbarnum2">Giving</a></td>		<td class="navbarnum2" valign="top" align="left" title=""><img src='images/givingnav_btwn.gif' alt=""></td>		<td class="navbarnum2" valign="top" align="left" title=""><a href="body.cfm?id=11"  class="navbarnum2">Volunteer</a></td>		<td class="navbarnum2" valign="top" align="left" title=""><img src='images/givingnav_btwn.gif' alt=""></td>		<td class="navbarnum2" valign="top" align="left" title=""><a href="http://hr.healthcare.ucla.edu"  target=""_blank"" class="navbarnum2">Jobs</a></td>		<td class="navbarnum2" valign="top" align="left" title=""><img src='images/givingnav_btwn.gif' alt=""></td>		<td class="navbarnum2" valign="top" align="left" title=""><a href="body.cfm?id=15"  class="navbarnum2">FAQs</a></td>		<td class="navbarnum2" valign="top" align="left" title=""><img src='images/givingnav_btwn.gif' alt=""></td>		<td class="navbarnum2" valign="top" align="left" title=""><a href="body.cfm?id=77"  class="navbarnum2">Contact</a></td>	</tr></table>
	
		<!-- End NavBar Output -->
	 

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								<td width="0%" height="28" align="right" style="padding-right:21px; vertical-align:middle;">























	


<table cellpadding="0" cellspacing="0" class="msd_fontsize_relative">
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		<td class="msd_fontsize_relative increase"><img class="msd_fontsize_relative" id="msd_increase" src="images/msd_fontsize/increase.gif" onmouseover="javascript:if(msd_fontsizeGetCookie() <4){this.src='images/msd_fontsize/increase_on.gif';};" onmouseout="javascript:if(msd_fontsizeGetCookie() <4){this.src='images/msd_fontsize/increase.gif';}else{this.src='images/msd_fontsize/increase_.gif';};" onclick="javascript:if(msd_fontsizeGetCookie() >= 4){this.src='images/msd_fontsize/increase_.gif';}else{msd_fontsizeIncrement('+');document.getElementById('msd_decrease').src='images/msd_fontsize/decrease.gif';};" alt="Increase (+)"></td>
	
	
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		<td class="msd_fontsize_relative after">Font Size</td>
	
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									<td class="leftnav" id="cLinkTD_84_1"><a href="body.cfm?id=84&amp;oTopID=42" class="leftnav">Spiritual Care</a></td>
							
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						<td class="leftnav" id="pLinkTD_45_1"><a href="body.cfm?id=45&amp;oTopID=45" class="leftnav">For International Patients</a></td>
				
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						<td class="leftnav" id="pLinkTD_51_1"><a href="http://www.mednet.ucla.edu" class="leftnav" target="_blank">For Staff</a></td>
				
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						<td class="leftnav" id="pLinkTD_711_1"><a href="body.cfm?id=711&amp;oTopID=711" class="leftnav">Watch our Webcasts</a></td>
				
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<a href="body.cfm?id=18"><img class="sm6generalwizard" src="images/best_hospitals.gif" border="0" width="140" height="167" style="width: 140px; height: 167px" /><br />
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									<table width="100%" border="0" cellpadding="0" cellspacing="0" style="background-image: url(images/navbar_tile.gif); background-repeat: repeat-x; background-position: top left;" onMouseOut="DHTMLRestoreAll();">
                    <tr> 
                      <td height="21" valign="top">											
												


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	//aryDHTMLMoused = new Array();
	var aryDHTMLLayerMoused = new Array();
	var DHTMLrunMouseOvers = false;
	var aryDHTMLMoImages = new Array();
	var DHTMLimageList = new Array();
	var DHTMLTimerID=null;
	//DHTMLiLimit=25;
	var itmp=0;

	function DHTMLMOImage()
	{
		var a = DHTMLMOImage.arguments;
		this.ptrImage = DHTMLNavBarMM_findObj(a[0]);
		this.imageMO = new Image();
		this.imageMO.src = a[1];
		this.HTMLname = a[0];
		this.Moused = false;
		this.OriginalSrc = '';
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	// 0) html image name 1) mo image src 2)image Name for rollover key (rollover may have multiple mos for one html Image)
	function DHTMLNavBarImagePreload()
	{
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		imageKey = (arg[2])?arg[2]:arg[0];
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			imageKey = (a[2])?a[2]:a[0];
			if(!(aryDHTMLMoImages[imageKey].ptrImage)){
				aryDHTMLMoImages[imageKey].ptrImage = DHTMLNavBarMM_findObj(a[0]);
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			{
				aryDHTMLMoImages[imageKey].OriginalSrc = a[1];
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		DHTMLNavBarTemponload = window.onload;
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			DHTMLNavBarTemponload();
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		DHTMLrunMouseOvers = true;
		return true;
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	function DHTMLNavBarMouseOutTimer()
	{
		if(DHTMLTimerID) { clearTimeout(DHTMLTimerID); }
		DHTMLTimerID = setTimeout("DHTMLNavBarLayerRestore()",5000);
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	function DTHMLRestoreParent(layername)
	{
		for(var i=0;i < aryDHTMLLayerNames.length;i++)
		{
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			{
				//alert(aryDHTMLLayerNames[i].indexOf("grand"));
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					DHTMLNavBarRestoreLayers(aryDHTMLLayerNames[i]);
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	}

	function DHTMLRestoreAll()
	{
		DHTMLNavBarMouseoverRestore();
		DHTMLNavBarLayerRestore();
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	function DHTMLNavBarMouseoverRestore()
	{
		var i = 0;
		var o = null;
		if (DHTMLrunMouseOvers)
		{
			for (var i=0; i < DHTMLimageList.length; i++)
			{
				if (aryDHTMLMoImages[imageList[i]].Moused && (o = aryDHTMLMoImages[imageList[i]].ptrImage)) {
					o.src = aryDHTMLMoImages[imageList[i]].OriginalSrc;
					aryDHTMLMoImages[imageList[i]].Moused = false;
				}
			}
		}
		return true;
	}

	function DHTMLNavBarLayerRestore()
	{
		for(var i=0;i < aryDHTMLLayerNames.length;i++)
		{
			if(!aryDHTMLNavBarLayerInfo[aryDHTMLLayerNames[i]].isDefault) {
				DHTMLNavBarRestoreLayers(aryDHTMLLayerNames[i]);
			}
		}
	}

	function DHTMLNavBarArrayPushUnique(aryArray, varNewElement)
	{
		//only pushes if unique value
		var pushIt = true;
		for (var i=0;i < aryArray.length && pushIt;i++) {
			pushIt = (varNewElement!=aryArray[i]);
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		if(pushIt) {
			DHTMLNavBarArrayPush(aryArray, varNewElement);
		}
		return pushIt;
	}

	function DHTMLNavBarArrayPush(aryArray, varNewElement)
	{
		//Implement Array Push 'cause IE cant handle it
		aryArray[aryArray.length]=varNewElement;
	}

	function DHTMLNavBarArrayPop(aryArray)
	{
		//Implement Array Pop 'cause IE cant handle it before 5.5
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			aryArray[aryArray.length]=null;
		}
		return varItemToPop;
	}

	var registeredObjects = new Array();
	//v3.0 name changed to avoid clash with possible other JS in content, this function complements of MM Dreamweaver
	function DHTMLNavBarMM_findObj(n, d)
	{
	
		x = document.getElementById(n);
		return x;
		
	}

	var DHTMLNavBarTime         = 100;
	var DHTMLNavBarTimes        = 2;
	var DHTMLNavBarmoveDistance = 1;
	var DHTMLNavBarThisLoc      = 325;
	var aryDHTMLLayerNames      = new Array();
	var aryDHTMLNavBarLayerInfo = new Array();
	var aryDHTMLNavBarLayers    = new Array();

	function DHTMLNavBarArrayContains()
	{
		var a = DHTMLNavBarArrayContains.arguments;
		var foundit = false;
		for(var i=0; i < a[0].length && !foundit; i++) {
			foundit = (a[1]==a[0][i]);
		}
		return foundit;
	}

	function DHTMLNavBarRegisterLayer()
	{
		var a = DHTMLNavBarRegisterLayer.arguments;
		var n = a[0];
		var d = a[1];
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			var mo = true;
		} else {
			var mo = false;
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		//alert(n + " -- " + d);
		if(!(DHTMLNavBarArrayContains(aryDHTMLLayerNames,n)))
		{
			if(o = DHTMLNavBarMM_findObj(n))
			{
				aryDHTMLNavBarLayers[n] = o;
				DHTMLNavBarArrayPushUnique(aryDHTMLLayerNames,n);
				aryDHTMLNavBarLayerInfo[n] = new DHTMLNavBarLayer(n,d,mo);
			}
		}
	}

	// v3.0 name changed, this function complements of MM Dreamweaver with customizations
	function DHTMLNavBarMM_showHideLayers()
	{
		var i,p,v,x,obj,args = DHTMLNavBarMM_showHideLayers.arguments;
		if(args[args.length-1] != "menu") { DHTMLNavBarMouseOutTimer(); }
	  	for (var i=0; i<(args.length-2); i+=3)
		{
			if(!aryDHTMLNavBarLayers[args[i]]) {
				x = (args[i+2]=='show')?'hide':'show';
				DHTMLNavBarRegisterLayer(args[i],x);
			}
	  		if ((obj=aryDHTMLNavBarLayers[args[i]])!=null)
			{
				v = args[i+2];
				aryDHTMLNavBarLayerInfo[args[i]].isDefault = false;
	  			if(args[args.length-1] == "restore") {
					v = (v=='show')?'hide':'show';
				}
				if (obj.style){
					obj.style.visibility = (v=='show')?'visible':(v='hide')?'hidden':v;
				} else {
					obj.visibility = v;
				}
			}
		}
	}

	// v3.0 name changed, this function complements of MM Dreamweaver with customizations
	function DHTMLNavBarMM_showHideGrandLayers()
	{
		var i,p,v,x,obj,args = DHTMLNavBarMM_showHideGrandLayers.arguments;
		if(args[args.length-1] != "menu") { DHTMLNavBarMouseOutTimer(); }
	  	for (var i=0; i<(args.length-2); i+=3)
		{
			if(!aryDHTMLNavBarLayers[args[i]]) {
				x = (args[i+2]=='show')?'hide':'show';
				DHTMLNavBarRegisterLayer(args[i],x);
			}
	  		if ((obj=aryDHTMLNavBarLayers[args[i]])!=null)
			{
				v = args[i+2];
				aryDHTMLNavBarLayerInfo[args[i]].isDefault = false;
	  			if(args[args.length-1] == "restore"){
					v = (v=='show')?'hide':'show';		
				}
				if (obj.style){
					obj.style.visibility = (v=='show')?'visible':(v='hide')?'hidden':v;
				} else {
		 			obj.visibility = v;
				}
			}
		}
	}

	function DHTMLNavBarRestoreLayers()
	{
	  	var i,p,v,obj,args = DHTMLNavBarRestoreLayers.arguments;
	  	for (var i=0; i<(args.length); i++)
		{
			//alert(args[i]);
	  		if (obj = aryDHTMLNavBarLayers[args[i]])
			{
				v = aryDHTMLNavBarLayerInfo[args[i]].defaultVisibility;
				var strobjid = obj.id;
				if (obj.style)
				{
					obj=obj.style;
					//alert(strobjid + " -- " + obj.visibility);
					v=(v=='show')?'visible':(v='hide')?'hidden':v;
				}
				obj.visibility = v;
				if (!aryDHTMLNavBarLayerInfo[args[i]].MOutLayer) {
					aryDHTMLNavBarLayerInfo[args[i]].isDefault=true;
				}
			}
		}
	}

	function DHTMLNavBarLayer()
	{
		var a = DHTMLNavBarLayer.arguments;
		this.defaultVisibility = a[1];
		this.isDefault = true;
		this.MOutLayer = a[2];
	}

	var viz = "hide";
	function DHTMLNavBarNavMove()
	{
		if(thisl==DHTMLNavBarMM_findObj("DHTMLNavBarScrollLayer"))
		//test for (==) mistyped as assignment (=)? -rls
		{
			if(thisl.style)
			{
				thisl=thisl.style;
				viz="hidden";
			}
			thisl.top = DHTMLNavBarThisLoc -= 3;
			if(DHTMLNavBarThisLoc < -750)
			{
				DHTMLNavBarThisLoc=325;
				DHTMLNavBarTimes--;
			}
		}
		if (DHTMLNavBarTimes<=0)
		{
			otherl=DHTMLNavBarMM_findObj("DHTMLNavBarLayer");
			otherl.visibility=viz;
		}
		else setTimeout("DHTMLNavBarNavMove()",DHTMLNavBarTime);
	}

	function DHTML_swapImgRestore()
	{ //v3.0
	  	var i,x,a=document.Sliding_sr;
	  	for(var i=0; a && i<a.length && (x=a[i]) && x.oSrc; i++) {
			x.src=x.oSrc;
		}
	}

	function DHTML_preloadImages()
	{ //v3.0
	  	var d=document;
	  	if(d.images)
	  	{
	  		if(!d.Sliding_p) {
				d.Sliding_p=new Array();
			}
	 		var i,j=d.Sliding_p.length,a=DHTML_preloadImages.arguments;
			for(var i=0; i < a.length; i++)
			{
		 		if (a[i].indexOf("#")!=0)
				{
					d.Sliding_p[j]=new Image;
					d.Sliding_p[j++].src=a[i];
				}
			}
		}
	}

	function DHTML_findObj(n, d)
	{ //v4.01
	  	var p,i,x;
	  	if(!d) {
	  		d=document;
		}
		if((p=n.indexOf("?"))>0 && parent.frames.length)
		{
		 	d=parent.frames[n.substring(p+1)].document;
			n=n.substring(0,p);
		}
	  	if(!(x=d[n]) && d.all) x=d.all[n];
		for (var i=0; !x && i<d.forms.length; i++) {
			x = d.forms[i][n];
		}
	  	for(var i=0; !x && d.layers && i<d.layers.length; i++) {
			x = DHTML_findObj(n,d.layers[i].document);
		}
	  	if(!x && d.getElementById) {
			x=d.getElementById(n);
		}
		return x;
	}

	function DHTML_swapImage()
	{ //v3.0
		var i,j=0,x,a=DHTML_swapImage.arguments;
		document.Sliding_sr=new Array;
		for(var i=0; i<(a.length-2); i+=3)
		{
			if ((x=DHTML_findObj(a[i]))!=null)
			{
				document.Sliding_sr[j++] = x;
				if(!x.oSrc) {
					x.oSrc=x.src;
				}
				x.src = a[i+2];
			}
		}
	}

	function DHTMLNavBarSwapRollover(swapimage,defaultimage,imageID)
	{
		if(imageID.length > 0 && document.getElementById(imageID))
		{
			if(swapimage.length > 0) {
				document.getElementById(imageID).src = "images/" + swapimage;
			}else{
				document.getElementById(imageID).src = "images/" + defaultimage;
			}
		}
	}
	window.onload = DHTMLFullyLoaded;
	
		// -->
		</script>
	
		<table border="0" cellpadding="0" cellspacing="0">
			<tr>
		
				<td valign="top">
				
			<div id="lryParentmain54" class="Parentmain1" onmouseover="DHTMLRestoreAll();;DHTMLNavBarMM_showHideLayers('lyr54','','show','lyrTopMO1','','show','lyrLeftMO1','','show','menu');">
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				<tr id="pRow54" style="vertical-align: top; background-color: transparent;" >
			
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						<tr id="cRow54_1" style="vertical-align: top; background-color: transparent;"  onmouseover="">
						
								<td valign="top" class="ChildNav1" style="" id="cLink54_1"><a href="body.cfm?id=479" target="" class="clSubb1">Physician Directory</a></td>
							
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							<tr>
								<td valign="top"><img src='images/c_btwn.gif'></td>
							</tr>
							
						<tr id="cRow54_2" style="vertical-align: top; background-color: transparent;"  onmouseover="">
						
								<td valign="top" class="ChildNav1" style="" id="cLink54_2"><a href="body.cfm?id=308" target="" class="clSubb1">Physician Referral Service</a></td>
							
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							<tr>
								<td valign="top"><img src='images/c_btwn.gif'></td>
							</tr>
							
						<tr id="cRow54_3" style="vertical-align: top; background-color: transparent;"  onmouseover="">
						
								<td valign="top" class="ChildNav1" style="" id="cLink54_3"><a href="body.cfm?xyzpdqabc=0&id=479&action=list&subaction=specialty&searchaction=simple&specialtygroups=family medicine,internal medicine,geriatric medicine,pediatrics,obstetrics & gynecology" target="" class="clSubb1">Show Primary Care Physicians by Specialty</a></td>
							
						</tr>
						
							<tr>
								<td valign="top"><img src='images/c_btwn.gif'></td>
							</tr>
							
						<tr id="cRow54_4" style="vertical-align: top; background-color: transparent;"  onmouseover="">
						
								<td valign="top" class="ChildNav1" style="" id="cLink54_4"><a href="body.cfm?xyzpdqabc=0&id=479&action=list&subaction=location&searchaction=simple" target="" class="clSubb1">Show Primary Care Physicians by Location</a></td>
							
						</tr>
						
							<tr>
								<td valign="top"><img src='images/c_btwn.gif'></td>
							</tr>
							
						<tr id="cRow54_5" style="vertical-align: top; background-color: transparent;"  onmouseover="">
						
								<td valign="top" class="ChildNav1" style="" id="cLink54_5"><a href="body.cfm?id=932" target="" class="clSubb1">Voted Best Doctors</a></td>
							
						</tr>
						
							<tr>
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							</tr>
							
					</table>
					
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			</div>
			
				</td>
				
				<td valign="top">
				
			<div id="lryParentmain53" class="Parentmain1" onmouseover="DHTMLRestoreAll();;DHTMLNavBarMM_showHideLayers('lyr53','','show','lyrTopMO1','','show','lyrLeftMO1','','show','menu');">
			<table border="0" class="ParentNav1" width="100%" cellpadding="0" cellspacing="0">
				<tr id="pRow53" style="vertical-align: top; background-color: transparent;" >
			
					<td valign="top" style="" id="pLink53"><a href="body.cfm?id=53" target=""><img src="images/btn_offices.gif" border="0" id="btn_offices_1_2" onMouseOver="DHTML_swapImage('btn_offices_1_2','','images/btn_offices_on.gif',2);" onMouseOut="DHTML_swapImgRestore();" alt="Medical Offices" /></a></td>
			
				</tr>
			
			</table>
			
						<div id="lyr53" class="clLeft1" onMouseOut="DHTMLRestoreAll();" DHTML_swapImage('btn_offices_1_2','','images/btn_offices_on.gif',2);">
					<table cellpadding="0" cellspacing="0" class="ChildNav1" border="0">
						
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																			<h1 class="pagetitle" id="pagetitle"><strong>For Patients & Visitors</strong> / Health Forms</h1>
																		
																	
																
															
															
															
															
																











	<h2>Instructions prior to your surgery </h2>
<p>
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. Please select the documents below according to the hospital where you are scheduled to have surgery. 
</p>
<h2>For Patients at Ronald Reagan UCLA Medical Center&nbsp;</h2>
<ul>
	<li>Important Information Regarding Your Surgery (<a href="workfiles/documents/healthforms/rr-patient-info-package-2008.pdf" target="_blank" title="Important information regarding your surgery">English</a>&nbsp;or&nbsp;<a href="workfiles/documents/healthforms/rr-patient-info-package-2008-esp.pdf" target="_blank" title="INFORMACI&Oacute;N IMPORTANTE SOBRE SU INTERVENCI&Oacute;N QUIR&Uacute;RGICA">Spanish</a>)<br />
	Please read this carefully and follow the instructions. </li>
	<li>Fill out and bring with you the two attached forms: 
	<ul>
		<li><a href="workfiles/documents/healthforms/admission-medication-history.pdf" target="_blank">Admission Medication History Form</a> </li>
		<li><a href="workfiles/documents/healthforms/medical-history-form.pdf" target="_blank">Health History</a></li>
	</ul>
	</li>
	<li>Patient Checklist (<a href="workfiles/documents/healthforms/patient-checklist.pdf" target="_blank">English</a>&nbsp;or&nbsp;<a href="workfiles/documents/healthforms/patient-checklist-esp.pdf" target="_blank">Spanish</a>)</li>
</ul>
<p>
Make sure you have completed all the items that pertain to you. 
</p>
<hr />
<h2>For Patients at Santa Monica-UCLA Medical Center and Orthopaedic Hospital </h2>
<ul>
	<li>Important Information Regarding Your Surgery (<a href="workfiles/documents/healthforms/sm-patient-info-package-2007.pdf" target="_blank">English</a>&nbsp;or&nbsp;<a href="workfiles/documents/healthforms/sm-patient-info-package-2007-esp.pdf" target="_blank">Spanish</a>)<br />
	Please read this carefully and follow the instructions. </li>
	<li>Fill out and bring with you the attached form: 
	<ul>
		<li><a href="workfiles/documents/healthforms/sm-admission-medication-history.pdf" target="_blank">Admission Medication History Form</a><a href="http://www2.healthcare.ucla.edu/healthforms/medical-history-form.pdf" target="_blank"></a></li>
	</ul>
	</li>
	<li>Patient Checklist (<a href="workfiles/documents/healthforms/sm-patient-checklist.pdf" target="_blank">English</a>&nbsp;or&nbsp;<a href="workfiles/documents/healthforms/sm-patient-checklist-esp.pdf" target="_blank">Spanish</a>)</li>
	<li>Additional information for <a href="body_sanmon.cfm?id=681" title="UCLA Orthopaedic/Spine Preoperative Instructrions">Orthopaedic and Spine Surgery patients</a>&nbsp; </li>
</ul>
<p>
Make sure you have completed all the items that pertains to you. 
</p>
<p>
To view these forms, Adobe Acrobat Reader is required. 
</p>
<p>
<a href="http://www.adobe.com/products/acrobat/readstep2.html" target="_blank"><img class="sm6generalwizard" src="images/get_adobe_reader.gif" border="0" width="88" height="31" /></a> 
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