At Campus Surgery Center, your time is as valuable to us as it is to you. Upon scheduling your surgery, a member of our staff will provide you with the required forms to fill out. We encourage you to take time to complete these before arriving on day of surgery, so that we may care for you promptly. If you happen to misplace any of the provided forms, duplicates are available for download and print below.
*You may print and complete, however you cannot sign the documents prior to checking in at the Surgery Center.
*Consent for AdmissionDownload
HIPAA Release FormDownload
Anesthesiologist’s Assignment of BenefitsDownload
Patient Health HistoryDownload
Pain Medicine Patient Health HistoryDownload
Patient Rights and ResponsibilitiesDownload
*Medicare Short Form (for our Medicare patients only)Download