SoutheastHEALTH’s COVID-19 provider/nurse triage line is available 24/7 at 573-519-4983. Anyone experiencing symptoms may use this number to speak with a health care provider. It is also available for patients, clinicians, and anyone in the community who has COVID-19 specific questions.
We continue to monitor the outbreak of coronavirus (COVID-19). Find Out More.
Please call 573-651-5830 for questions regarding this form.
This information will be reviewed by your Anesthesiologist prior to surgery and will help to prepare and provide safe anesthesia and nursing care for you.
If you would like us to maintain a copy of your Advance Directives on your medical record, please bring it with you.
If you would like us to create an Advance Directive, please print and complete the form and bring it with you. If you have any questions, do not hesitate to discuss them with us.