One Medical Passport
Facility/Physician Office Information

 Select the one option that best describes your Medical Passport.

 Medical Facility
and Physician
Patients scheduled for Surgery, Pain Management Procedure/Consult, Preoperative Testing, or a Medical Procedure should choose this option.  Your information will be accessible to qualified staff of the medical facility and to your doctor.
 Personal Use OnlyUse this option to create a Medical Passport for your own personal use. Note: You should not select this option if you are having a procedure at a medical facility.