The forms listed below are provided for your convenient review. Please note that the informed consent forms (Surgery and Anesthesia) are for informational purposes only. You will review these with your surgeon and anesthesiologist in person.
Acknowledgement of Notice Of Privacy Practices and Financial Policy
Day of Surgery Facility Consent
Notice of Privacy Practices
Pacific Anesthesia Consent
Patient Financial Responsibility Form
Patient Rights and Responsibilities
Proliance Surgeons Informed Consent