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The Department of Obstetrics and Gynecology Residency Program Online Experience Forms The George Washington University Medical Center
Clinical Responsibilities                                                                             Printable Version

Brief Operation Note Template

Date/Time Preop diagnosis: reason for surgery
Postop diagnosis: actual finding at surgery
Procedure: performed
Anesthesia: type; i.e, general, spinal, epidural, etc
Surgeon: attending physician
Assistant(s): resident/medical student
Estimated Blood Loss:
IV Fluids:
Urine output:
Findings: in detail what was found at surgery, describe sizes, Adhesions, etc
Pathology: what was sent to the pathologist for evaluation
Disposition: where patient is going from operating room

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Last Modified: October 3, 2007
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