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Patient Information & Forms

Meet our Patients

The siblings in the Hickey family had more in common than their last name, they both received the Nuss Procedure at CHKD. Read their story.

Patient Information

The following documents provide more detailed information about the Nuss procedure, patient rights and our privacy practice. Adobe Acrobat Reader viewer may be required to view these files. To download the latest version click on the icon below.

• Patient Evaluation Guidelines
• Insurance Information
• Your Child's Visit
• Brief Overview of Pectus Excavatum
• What to Expect About the Surgery
• Pain Relief After Surgery
• Discharge Instructions
• Bar Removal Procedure
• Notice of Privacy Practice
• HIPAA Information

Forms

Please click print and complete these forms prior to your appointment. You may fax or mail these documents to Pediatric Surgery-Pectus Program prior to your appointment:

Children's Hospital of The King's Daughters
Pediatric Surgery-Pectus Program, 5th Floor
601 Children's Lane
Norfolk, VA 23507
Fax: (757) 668-8860

• Pectus Excavatum Patient Evaluation
• Registration Form
• Patient Questionnaire
• HIPAA Consent/Acknowledgement Form