Tonsillectomy Post-Operative Evaluation Form
Patient Information
Patient Name
Date of Birth
Date of Surgery
Surgeon
Post-Operative Assessment
Pain Level (0-10)
Fever
Yes
No
Bleeding
Yes
No
Difficulty Swallowing
Yes
No
Vomiting
Yes
No
Oral Intake Adequate
Yes
No
Signs of Infection (e.g., redness, swelling)
Yes
No
Other Observations / Notes
Comments
Follow-Up
Next Appointment Date
Time
Evaluator Name
Date of Evaluation