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The patient IS clear to proceed as scheduled.  \n  Further testing is necessary to gauge the patient’s risk for an invasive procedure as the patient is at prohibitive risk from a Cardiac standpoint. The patient is NOT yet released for the procedure.  \n  The patient is at increased risk from a Cardiac standpoint but is cleared for the procedure with the following recommendations:  \n1.    \n2.    \n  The patient MAY stop the following medications 7 days prior to surgery:     The patient MAY NOT stop the following medications for surgery:   \nPhysician’s Name (Print)    \nPhysician’s Signature:   Date:","cbCaiqGPBvtakNsN","https://ap.wps.com/l/cbCaiqGPBvtakNsN","pdf",433295,"English","# Cardiac Clearance Request\n## Request Type\n## Patient and Referral Information\n## Pre-Procedure Requirements\n## Clearance Options and Recommendations\n## Physician Confirmation","[{\"question\":\"What pre-procedure requirements are listed on the form?\",\"answer\":\"The form states the patient will need general anesthesia and should hold all blood thinners 7 days prior to surgery if applicable.\"},{\"question\":\"How does the form define the clearance outcomes?\",\"answer\":\"It offers options for low cardiac risk (cleared), prohibitive risk requiring further testing (not released), or increased risk with conditional clearance and specific recommendations.\"},{\"question\":\"What information must the physician provide to finalize the request?\",\"answer\":\"The physician must provide the printed name, signature, and the date.\"}]","Cardiac Clearance Request - Orthopaedic Surgery Standard Request Form | PDF",1789561874]