Our "Passport to Surgery," a pre-op form staff must complete and include in the patient's chart before that patient can enter the OR, was born out of frustration regarding missing history and physical examinations. Surgeons wrote H&P regulations into the hospital's bylaws and we nurses were told on numerous occasions that H&Ps were incomplete or incorrect when patients presented for surgery, but no one seemed to have an answer when pressed for H&P requirements. Cases were delayed, fingers were pointed and frustration levels began to rise.