Patient Forms and Resources
Patient Resources
Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so you can accelerate your check-in process. Please download, print, and complete the forms and bring them with you to your appointment. If you are unable to download our patient forms, then it is recommended that you arrive at your appointment 15 – 30 minutes early so you can have ample time to fill out the appropriate forms.
Covid-19 Informed Consent
South County Outpatient Surgery Center's Covid-19 Consent Form
Privacy Policy
South County Outpatient Surgery Center's Privacy Policy
Patient's Bill of Rights Form
Summary of the Florida Patient's Bill of Rights and Responsibilities
Authorization to Release Info
Authorization to Release Information and Assignment of Benefits form
Notice of Policies
Notice of Policy Regarding Advanced Medical Directives, Informed Consent, Physician Financial Interest in Center, Patient Bill of Rights and Notice of Privacy
Medication Reconciliation
South County Outpatient Surgery Center's Medication Reconciliation form
*Individual results are not guaranteed and may vary from person to person. Images may contain models.