Medical knowledge, Patient Education
Form – Surgical Drain Record
Empty your surgical drain as told by your health care provider. Use this form to write down the amount of fluid that has collected in the drainage container. Bring this form with you to your follow-up visits.
Surgical drain #1 location: ___________________
Date __________ Time __________ Amount __________
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Surgical drain #2 location: ___________________
Date __________ Time __________ Amount __________
Date __________ Time __________ Amount __________
Date __________ Time __________ Amount __________
Date __________ Time __________ Amount __________
Date __________ Time __________ Amount __________
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This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
