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Height (cm): Weight (kg): BMI: BP: HR:
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Creative Commons License
The SPOC (Surgical Patient Optimization Collaborative) PreOp & PreHab eForm V19_Jan31_2021 by Gunther Klein and John Yap, is licensed under aGPL.
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Prehabilitation Resources

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    • Resources:

  • (get eForm)

    • Specify risk, select one:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 57-58)
  • (get eForm)

    • Specify risk, select one:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 35-57)
  • Revised Cardiac Risk Index
  • (get eForm)

    • Specify risk, select all that may apply:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 59-62)
  • Clinical Frailty Scale
  • Staying Active as You Age
  • Medication Review Services
  • Goals of Care
  • Time Up and Go (TUG Test)
  • MSPSS Scale of Perceived Social Support
  • Your Surgery Journey: Back Home YouTube
  • Home & Community Care Services
  • (get eForm)

    • Specify risk, select all that may apply:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 47-49)
  • Self Management BC
  • CHANGE Pain Clinic
  • Pain BC
  • (get eForm)
  • (get eForm)

    • Select all that may apply (reset if error):



    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 55-56)
  • CAGE-AID
  • TAPS Tool
  • Alcohol Abuse Intervention
  • HealthLinkBC.ca
  • Dr. Mike Evans - Smoking Cessation YouTube
  • Quitnow.ca
  • Quitnow BC – Quit Plan Registration
  • (get eForm)

    • Specify risk, select one:

  • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 19-21)
  • Canadian Nutrition Screening Tool
  • Healthy Eating for Seniors
  • Healthy Eating 101 YouTube

    • Specify risk, select one:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 53)
  • Mental Health Meter
  • Here to Help BC
  • Anxiety Canada
  • (get eForm)

    • Specify risk, select one:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 39-41)
  • Diabetes Canada: Pt's story YouTube
  • Diabetes Canada: Managing my Diabetes
  • (get eForm)

    • Specify risk, select one:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 43-45)
  • HealthLink BC
  • Canadian Physical Activity Guidelines
  • ParticipACTION
  • 23 ½ Hours YouTube
  • Sit to Stand YouTube
  • Walking Up Stairs YouTube
  • Knee Bends YouTube

    • Specify risk, select all that may apply:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 31-33)
  • Sleep Apnea YouTube
  • Sleep Apnea Information – Mayo Clinic
  • (get eForm)
  • (get eForm)

    • Specify risk, select all that may apply:

    • Resources:

  • BC Surgical Prehabilitation Toolkit(pg 27-31)
  • Caprini VTE Risk Assessment Model

    • Select one:

    • Specify indication & need for bridging