Patient Registration Forms & Privacy Notices

If you are a new patient, please fill out the forms listed below in advance of your appointment to assist the Coastal Surgery Center staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment.

New Patient Forms Click Here to Sign Document
  Patient Update Click Here to Sign Document
  Panniculectomy Questionnaire Click Here to Sign Document
  Septoplasty Questionnaire Click Here to Sign Document
  Breast Reduction Questionnaire Click Here to Sign Document
  Pre-Op Form Click Here to Sign Document
  Local Pre-Op Click Here to Sign Document
  Medication Reconciliation Click Here to Sign Document
  Medical Records Release Click Here to Sign Document
  Minor Consent Click Here to Sign Document
  Business Associate¬† Agreement (BAA) Click Here to Sign Document
 

Preop Paperwork

Privacy Notices

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

*** Privacy Notice Coming Soon ***

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