• Welcome to Your Pre Operative Planning! 👏
    As an extension of our reimagine experience in healthcare, this pre op prepartion form is designed to be completed from the comfort of your home, on your mobile phone.  

    • You will need to allocate 10-15 minutes to complete the entire form.  
    • If there are missing sections we are unable to proceed with your surgery.
    • The form is secure & encrypted – Your information is protected by the same security standards used by major financial institutions. 

    Before You Begin - Please Have Ready:

    • Your current medications list (including dosages)
    • Your Primary Doctor's contact information
    • Your Pharmacy's name and address
    • Details about any medical conditions you manage
    • 10-15 minutes of uninterrupted time


    Important Reminders:

    • Please answer all questions completely and honestly - this helps us keep you safe.
    • Be sure to list ANY allergies to medications, latex, iodine, or adhesives.
    • Your information is confidential, and securely encrypted. 
    • You can save and return to this form if needed.
    • Our team will contact you within 24-48 hours after submission to confirm next steps.


    Ready to get started? Let's do this!

  • Let's talk about you...

  • Do you exercise regularly?*
  • How would you rate your exercise level?*
  • Do you have any of the following medical conditions?*

  • Please tell us about your heart disease...

  • Do you have any of the following heart conditions?*

  • Please tell us about your pulmonary disease...

  • Do you have any of the following?*

  • Please tell us about your sleep apnea...

  • Primary Medical Doctor

  • Please share the name, phone number and email address for your Primary MD. 

    If you do not have a Primary MD, you can provide the information for a doctor you have seen or will be seeing in the future for general care

  • Format: (000) 000-0000.

  • Pharmacy Info

  • Thank you for taking time to complete your pre op health history.  Please take time to review your answers and make sure that you have included all the details so our team is well versed on your medical background.

    If at any time you have questions, concerns or need more information, please connect with the support team at support@evofoot.com or Dr. Sadrieh directly by sending a message using the messaging button on our website.


    The support team is available to answer messages Monday – Friday, 9:00 AM to 5:00 PM*
    Dr. Sadrieh is available to answer messages 7 days a week*

    *Please note that we will answer text messages within 24 hours, and email in 24 hours to 3 days depending on priority. If you are communicating about an urgent issue, start your message with URGENT in ALL CAPS. If Dr. Sadrieh is in surgery or with a patient, he will respond to you when finished and available after the surgery/patient visit. We will always do our best to respond in minutes, but if time passes, do not worry… we have seen your message and are managing other patient tasks and will get back to you in order of the queue. We appreciate your understanding.

  • By signing this form, you agree that the information you have provided is truthful and completed by you, the patient. 

  • Should be Empty: