Forms: Surgery Information Packets

This packet contains general information about your surgery, billing and more. Please download and print this PDF Packet. (*required for ALL surgeries)

If your child is having surgery at Pediatric Surgery Centers Odessa or Tampa:


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To ensure you recieve the best care possible and to help you reduce long phone interviews and handwritten forms, Pediatric Surgery Centers offers an easy, online medical history questionare for you to complete at your convenience. You may also recieve a text message and email notification prompting you to complete this information online.

1. Start at your facility website:

2. In the top right hand corner select Medical History for the appropriate facility.
Medical History – ODESSA
Medical History – TAMPA

2. Click the green Register button, shown on Complete each questionnaire page and clinic Next to save and continue.

When you complete, click Finish to securely send us your information. If you need assistance, click the Help link located on every page.

New Patients-  Click Register to create an account.

Returning Patients- Enter username and password to update or finish your Medical Passport or to use information for any further procedures. Make note of the username and password you select for future.

If you are not able to complete your health history online, please call the pre-op nurse during business hours to complete your history over the phone.

ODESSA: 813-343-5690
TAMPA: 813-490-6100