Joint Works Patient Education Class Reservation

Surgical Schedulers please provide patient with FMH Pre-Surgical Education dates / times form for them to PICK their preferred class of attendance during their pre-op visit with their surgeon. Please complete this internet reservation form as their preference form indicates. Once completed, please print and provide the FMH Pre-Surgical Education registration confirmation to the patient with instructions for attendance to the class. This form serves as their registration confirmation for the class. Thank you! Any questions, contact Orthopaedic Program Coordinator 240-566-3785.


**In the event of inclement weather, an announcement will be made by 5PM on the prior day before scheduled class if class scheduled for 9am-11:30am. All other class times, 1pm-3:30pm and 5pm-7:30pm, will be made on the day of scheduled class by 10am. Announcements will be made on 106.9 FM and on fmh.org if class should need to be cancelled. **

Patient Name*
Email Address
Date of Birth*
Choose Class Date*
Date of Surgery*
Planned Length of Stay*
Interpreter Desired*
If Yes Please Enter Interpreter Type*
Wheelchair Desired*
1:1 Request*
Additional Requests/Concerns*