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Dr. Christian Eccles

                                                                                 Hip and Knee Replacement Surgery
                                                                       2940 E. Banner Gateway Dr. #200, Gilbert, AZ 85234
                                                                               1675 E Melrose St, #101, Gilbert, AZ 85297
                                                                               Phone: 480.964.2908 | Fax: 480.388.3519
                                                                              Medical Assistant (Reese) extension: 3186
                                                                             Surgery Scheduler (Debbie) extension: 4141




                                             IMPORTANT DATES

                                      Use this form to keep track of your appointments


                         Schedule a medical clearance appointment with your Primary Care Physician

                                       Date: ____________________  Time: _____________





                     If needed schedule a medical clearance appointment with your Specialty Physician(s)
                        Specialty: ____________________ Date: ____________________  Time: _____________



                       Specialty: ____________________ Date: ____________________  Time: _____________






                                   PRE-OPERATIVE APPOINTMENT WITH DR. ECCLES

                                       2940 E. Banner Gateway Dr, #200, Gilbert, AZ 85234

                                       1675 E Melrose St, #101, Gilbert AZ 85297


                                  Date: _________________  Time:_________________________

                   You need to have all pre-operative testing/clearances done before your appointment.






                                                SURGERY DATE AND TIME

                             Location: Arizona Spine & Joint  4620 E Baseline Rd, Mesa, AZ 85206


                   Date: _____________________  Time:  Debbie (Surgery Scheduler) will call you the afternoon

                                                                                           before with your check in time.
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