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Patient Information

For your convenience, we have provided patient related forms at the bottom of this page which can be downloaded and printed from home. Please bring these forms with you on the day of your visit. Thank you.

Thank you for your interest in our State-of-the -Art Facility at City Place Surgery Center!

Please feel free to Contact Us should you have any questions about our center or our services.

We'll be happy to get back to you on anything you'd like additional information about.







 

Patient Forms

Save time by printing and completing forms at your convenience.
To print some of our forms, Adobe Acrobat Reader is required.
If you do not already have Acrobat Reader, please click on the logo below for a fast and free download of the plug-in.



Patient Bill of Rights Form 2011
CPSC Advance Directives Consolidated
Patient Information Form
Accident Information Form
Business Admission Consent Form
Privacy Practices Policy



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City Place Surgery Center is a Meridian Surgical Partners facility.