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The day prior to the Gamma Knife procedure, the patient is evaluated at our outpatient area adjacent to the Gamma Knife facility. The patient is seen and examined by the neurosurgeon and an allied health provider or resident trainee in neurosurgery in order to review the risks and benefits of Gamma Knife radiosurgery. Appropriate labs are reviewed and orders are entered into the electronic health record. During this visit, the patient also meets with a dedicated Gamma Knife nurse with extensive training and experience in the procedure and all patient needs and expectations. The nurse will include the patient’s family members and significant others during this visit. The nurse will complete a nursing assessment and a brain imaging screening (since all patients have one or more types of medical imaging, such as MRI, CT scan, or a digital subtraction angiogram to localize the brain target). During this screening, the nurse will investigate whether or not the patient has any medical implants or metal exposure to the eyes. Implants must be cleared for the MRI and if there is a history of metal in the eyes the patient may need orbit X-rays to ensure it is safe to have the MRI. Blood work is often needed for imaging studies that require a contrast medium. Therefore, at this time the nurse will determine if the patient has recent lab values that can be used or send the patient to the laboratory to have the appropriate blood work drawn. A patient receiving gadolinium will need a creatinine level. Patients receiving iodine-based dye will need a recent creatinine and blood urea nitrogen test. Patients having an angiogram will need a basic metabolic panel as well as PT/PTT, INR, and platelets. This is also a good time to address any questions or misconceptions that the patient may have. Some common misconceptions include that Gamma Knife is performed using a “laser” to remove the tumors. Patients are frequently concerned that we will have to shave their head. Patients are usually relieved to learn that we do not remove any hair for the procedure. Many patients also express a concern that they will be “radioactive” and are worried that they will not be able to be around family and friends following the procedure. This preoperative evaluation is the perfect opportunity to address and answer any questions and concerns that the patient and their family members may have. During this question and answer session, the nurse begins to bond with the patient as well as the patient’s family members. Continuing the preoperative education of the patient, the nurse provides the patient and family members with a preprinted list of procedure day instructions. The instructions will include a phone number so the patient can reach the nurse directly for questions that may arise after they leave their initial appointment. The nurse also often gives the patient and their family members a tour of the Gamma Knife facility. The goal of the pre-radiosurgery nursing evaluation is that the patient and their family members leave the visit knowing exactly what to expect on the day of the procedure.