Thank you for choosing Surgical Associates, PC for your care.
Prior to your appointment, we would appreciate your taking the time to fill out these forms and bring them with you on the day of your appointment. Our medical records are separate from St. Vincent Healthcare because we are a privately owned medical practice. Please use blue or black ink when filling out the paperwork.
- Complete the Patient Registration form, sign and date the bottom
- Review the Billing & Payment Policy, sign and date the bottom
- Complete the Health History Intake Sheet, sign and date the last page
- Complete the Acknowledgement of Privacy Practices* form, sign and date the bottom
Click on the document titles below to view the forms.
The following forms are in PDF format. In order to view and print them, you will need the Free Adobe Reader. If you do not have Adobe Reader, you can Download it Here.