It is important to complete Simple Admit as soon as possible so that our medical team can review your information prior to your visit to ensure patient safety.
Please use the passwords below to access:
Adult Patient Password (ages 13+):
Pediatric Patient Password (ages 0-12):
Please allow between 15 and 20 minutes to complete the questionnaire - we recommend completing in one sitting, if possible.
If you have any questions about completing the form, please contact Simple Admit at (877) 848-4726.
You will receive a call from one of our pre-op RN's 1 to 2 business days prior to your scheduled procedure to review the information and to give you important instructions.