OHSU

Preliminary Checklist

Medical Requirements for Men by Age

18 - 49 years of age

  • Notes from your primary care provider covering the past two years
  • Laboratory results including: Lipid panel, CBC, CMP, TSH, Glycosolated Hemoglobin, Vitamin D 25-hydroxy, PTH, and H pylori antibodies
  • Sleep Study

50 – 54 years of age

All the above plus colonoscopy and pathology report

 

Over 55 years of age

  • All the above plus preoperative evaluation by a cardiologist
These tests do not have to be completed before seeing the nurse practitioner, but they must be completed before a surgery date is set.

 

Medical Requirements for Women by Age

18 – 39 years of age

  • Notes from your primary care provider covering the past two years
  • Laboratory results including: Lipid panel, CBC, CMP, TSH, Glycosolated Hemoglobin, Vitamin D 25-hydroxy, PTH, and H pylori antibodies.
  • Results of Pap test within the past year, unless you have had a hysterectomy
  • Sleep study

40 – 49 years of age

All the above plus mammogram within the past year

50 – 54 years of age

All the above plus colonoscopy and pathology report

Over 55

All the above plus preoperative evaluation by a cardiologist