Patient Forms and Instructions: Download and Print

---

New Pilonidal Patient Questionnaire

Are you a new patient looking for Pilonidal Surgery at The Sternberg Clinic? Please complete a New Pilonidal Patient Questionnaire to provide our office staff with your information and medical history. For more information read the Sternberg Clinic’s patient instructions and guidelines.

---

Pilonidal Cleft Lift Surgery
Post-Operative Instructions

If you have undergone surgery for Pilonidal Disease, read this document to prepare for surgery and plan your recovery after the operation. Download and Print

Download a copy of the Closed Suction Drain Output Record.

---

Patient FAQ
and Drain Video Instructions

Learn how to photograph your pilonidal disease for effective consultation for long-distance patients. Download and Print

Read our Pilonidal Surgery FAQ for an explanation on commonly asked questions.

Watch a video demonstrating how to care for the drain while recovering from Cleft Lift surgery, and how to remove it.

---

General Surgery
Patient Instructions

Anal Fissure Treatment Plan

An anal fissure is a ‘cut’ in the anal canal resulting from trauma. Most people suffering from an anal fissure experience pain during or after defecation (the act of moving one’s bowels, a number 2). Download and Print

Nitroglycerine​ ​Ointment​ ​0.2%

If you’ve been prescribed nitroglycerin ointment for your anal fissure, read our fact sheet for pharmacy locations and instructions for use. Download and Print

Rubber​ ​Band​ ​Hemorrhoid​ ​Ligation

You just had a rubber band or bands applied to you internal hemorrhoids. Here are a few things to be aware of. Download and Print

Suggestions​ ​for​ ​perianal​ ​care​ ​
in​ ​patients​ ​with​ ​itching​ ​or irritation

Read our suggestions for patients with perianal itching and other anal symptoms or conditions that can contribute to anal itching or discomfort. Download and Print

Taking​ ​a​ ​Fiber​ ​Supplement

There are many fiber supplements and all can be purchased without a prescription. Read our information sheet on how to select and use a fiber supplement. Download and Print

Thrombosed​ ​or​ ​Prolapsed​ ​Hemorrhoids

For patients with severe, circumferential thrombosed hemorrhoids and/or prolapsed hemorrhoids there are two primary treatment options. Download and Print

More Links and Patient Resources