Patient Forms and Instructions: Download and Print

Patient History Form

If you are a new patient at The Sternberg Clinic, please complete a patient history form and send it to our office staff at 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

Learn more about Insurance Coverage. Read more

Contact the Presidio Surgery Center. Visit the website

Login to the Athena Payment Portal. Login here

Contact our San Francisco Office

To learn more about treating your Pilonidal Disease with surgery and the Cleft Lift procedure, contact our office staff for information or to schedule an appointment.

Did Dr. Sternberg treat your pilonidal disease? Submit a Patient Testimonial

Appointment Hours

MonFriday: 9:00 am – 5:00 pm
Weekends: Closed

Featured in

The Sternberg Clinic Top Doctor

Member of ASCRS, Crohn’s & Colitis Foundation,
American College of Surgeons, and Pilonidal Support Alliance