The clinic model for anesthesiologists’ preoperative evaluation of patients is evolving. Historically, prior to the day of surgery, a patient was evaluated in person at an office. The visit established rapport and allowed the anesthesiologist to become familiar with the patient’s surgical illness, identify and medically optimize comorbidities, develop a perioperative management strategy, and obtain informed consent. Due to patient and hospital factors, this approach is being modified. Telemedicine consults are burgeoning as a cost- and time-saving method of accomplishing the same preoperative evaluation. Electronic consults, or eConsults, are also being used as a direct pathway of communication between the anesthesiologist and other patient providers. The anesthesiologist gathers clinical information through fragmented healthcare systems and synthesizes an overall clinical picture to determine optimization and complete workup prior to surgery. Physical examination and consent forms are completed on the day of surgery. Some centers with known low-risk patients and low-risk procedures defer the entire evaluation to the day of surgery. Regardless of the model of preoperative evaluation, the basic tenants remain the same.