Patient Forms

General Forms

• File

  Patient Information
• File

  Pre Op Health Questionnaire
• File

  Standard Pre Op Instructions
• File

  Local Pre Op Instructions
• File

  Facility Fee
• File

  Patient Rights and Responsibilities
• File

  Arbitration
• File

  HIPAA PRIVACY
• File

  NON DISCRIMINATION NOTICE
• File

  NON DISCRIMINATION NOTICE (SPANISH)
• File

  Right to Receive a Good Faith Estimate of Expected Charges
• File

  Notice Regarding Patient Protections Against Surprise Billing