Patient Forms

At Surgery Center of South Bay, 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.

Advanced Directives

Download

Notice of Privacy Practices

Download

Information of Separate Billing Notice

Download

Mission, Vision and Values

Download

Multiple Authorization

Download

Patient Information Guide

Download

Patient Registration

Download

Patient Rights and Notification of Physician Ownership

Download

Request for Anesthesia

Download