PATIENT FORMS

Before Your First Visit

Patient Registration (pdf)

Orthopedic History (pdf)

Medical Records

Authorization to Release Medical Records (Released to Slocum) (pdf)

Authorization to Release Medical Records (Released from Slocum) (pdf)

Notice of Privacy Practice (pdf)

Medical Records Amendment (pdf)

Request for Restriction (pdf)

Slocum Surgery Center

Patient Rights and Responsibilities (pdf)