Getting surgery? You will need a physical. Please have your physician fill out the Physical Evaluation form. Your physical exam needs to be less than 30 days old. This form is for all patients and is required for all patients undergoing surgery. No other form will be accepted by our surgery center. Should patients not have the physical form complete, it would delay any surgical procedure that may be required. For a child, their pediatrician must complete the form prior to your initial visit.