For your convenience, you may complete the required form online below.

If you do not wish to complete the form online, you are welcome to download both the Patient Access form (pdf) and the Anesthesia Pre-Operative Evaluation Clinic form (pdf), print and fill them out. ( NOTE: If you choose to fill out the print version, you will have to fill out two separate forms for Patient Access and the Anesthesia Pre-Operative Evaluation Clinic. Some of the information may be redundant, but we need you to fill them both out in full. ). You can fax them in advance to 713.441.5308. Once you’ve faxed your form, you will receive a follow up call from the APEC within 3 business days.


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