Patient Forms

At Ridgedale 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.

Our Patients’ Safety During COVID-19

COVID-19 Informed Consent

Our Commitment to Each Other: Patient & Provider’s Mutual Responsibilities During COVID (English)

Our Commitment to Each Other: Patient & Provider’s Mutual Responsibilities During COVID (Spanish)

Patient Rights Form

Financial Policy

Medical History/Reconciliation Form

Patient Disclosure Form

Patient Questionnaire