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Patient Forms

At West Bank 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.

Advance Directive Acknowledgement

Surgery Center Brochure

Balance Billing Disclosure

Contracted Providers Disclosure

General Consents/Financial Responsibility

Multiple Authorization Form

Patient Rights and Responsibilities

West Bank Owners