top of page
Surgery

Surgery Request Form
Important Information

Why Submitting a Surgery Request Form is Essential

​

Surgery is a precise and carefully planned medical procedure.

To ensure the highest level of safety, efficiency, and personalized care, it is crucial that all patients submit a surgery request form in advance.

 

This form allows Dr. GB Davids and the medical team to:

 Understand Your Needs – Provide details about the type of surgery you require, ensuring the best treatment plan is in place.


Assess Your Medical History – Review any conditions, allergies, or prior procedures that may impact the surgery.


Confirm Suitability – Evaluate whether you are a candidate for the procedure and if additional consultations or tests are necessary.


Plan Scheduling & Resources – Allocate the appropriate surgical team, equipment, and time needed for your procedure.

​

Without this form, we cannot guarantee an accurate assessment of your case, which may result in delays or rescheduling.

Will Dr. GB Davids Personally Perform Your Surgery?

​

Dr. GB Davids is an experienced and highly qualified surgeon dedicated to providing the best possible care.

While submitting a request form does not automatically guarantee that Dr. Davids will personally perform your procedure, it does ensure that:

​

Your case will be reviewed by Dr. Davids or a member of his trusted surgical team.​

​

If deemed appropriate, Dr. Davids will perform the surgery himself.

​

If scheduling conflicts arise, another qualified surgeon from his team may be assigned, but only after discussing your options with you.

​

Patient safety and surgical success are our top priorities, and all procedures are handled by highly skilled professionals.

Privacy & Data Protection – Your Information is Secure

​

We take your privacy seriously.

All information submitted through the surgery request form is protected under Applicable Privacy Laws, including:

​

HIPAA (Health Insurance Portability and Accountability Act) – If applicable, ensuring the confidentiality of your medical information.


GDPR (General Data Protection Regulation) – If you are in the EU, we comply with strict data protection and consent policies.


POPPIA – Protecting your personal data and ensuring it is only used for medical purposes.

​

Your details will only be accessed by authorized medical personnel involved in your care, and will never be shared without your consent.

Procedures and Minor surgical interventions form

Surgery is a delicate and highly specific process, requiring careful preparation.
To ensure Dr. GB Davids can provide the best care possible, we ask that you complete the surgery request form in advance.

55 Jan Van Riebeeck Dr, Denneburg, Paarl, 7646

Thanks for submitting!

bottom of page