Once you have viewed the educational video, please complete this required brief quiz below. When finished, click "Submit." Your results will be sent directly to the Spine Care Navigator, Shamaila Iqbal. If you have questions, please email either Shamaila Iqbal or Cathleen McCranie.

First Name

Last Name

Phone

Address

Address 2

City

State

Zip Code

Scheduled surgery date (if applicable)

Which Inova hospital?

At which Inova hospital are you having your surgery?

Please complete these questions:

1. I should shower with chlorhexidine gluconate* (CHG) before my surgery.

2. It is okay to continue taking aspirin before my surgery.

3. I should cough, deep breathe and do frequent ankle pumps after my surgery. I will be asked to get out of bed the day of my surgery. Even if I go home the day of surgery, walking and expanding my lungs (occasional deep breathe and cough) will prevent complications.

4. I will be asked to rate my pain using a 0-10 scale. 10 would indicate the highest level of pain.

5. Please include any additional questions you may have below.

Was our online education helpful?

Do you feel that this online education gave you the necessary information to prepare you for your upcoming spine surgery?

If no, what do you feel we could have done better?

Any additional comments?

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

By submitting this form, you are confirming that you would like to receive health and wellness information from Inova. You can unsubscribe if you find it is not meeting your needs.

Contact Us

Quiz for Spine Patients

Which Inova hospital?

Please complete these questions:

Was our online education helpful?