Pre-Admission Forms
For your convenience, you are welcome to download and review our admission forms prior to arriving at our center to expedite the registration process. Please do not sign the forms prior to your arrival, as our receptionist will serve as your witness.
*Consent for Admission
*Medicare Short Form (for our Medicare patients only)
The patient or responsible party should bring their insurance card(s) and a photo ID.
The patient or responsible party should bring their preferred payment method for any co-pays or balances.
The patient or responsible party should review carefully all of their information as listed on the chart. Spellings, addresses, and other demographic information should be reviewed.
All patients should have a ride home and a responsible adult to care for them that evening. For patient safety, we request that a responsible adult remain at the center with the patient at all times.
Parent(s) or legal guardians of pediatric patients (17 years of age or younger) need to remain at the Center at all times until dismissal. Legal guardians should bring with them any legal or guardianship papers.
If you have a Latex allergy, or think you may be pregnant, please call the surgical center to speak to the pre-op assessment coordinator.