Downloadable Forms

The following Forms are provided for Patients to print and fill out and bring into the office.
Filling these forms out helps streamline office visits and saves time.


PATIENT FORMS

If you are a GENERAL SURGERY patient, please fill out ALL of the forms below, excluding ONLY the BARIATRIC SURGERY PATIENT INFORMATION FORM.
If you are a BARIATRIC SURGERY patient, please fill out ALL of the forms below, excluding ONLY the GENERAL SURGERY PATIENT INFORMATION FORM.

Authorization Form (HIPPA Financial)
Download form
Bariatric Surgery Patient Health Information
Download form
Consent for Treatment at Western Surgical Group
Download form
Contracted Facilities
Download form
Financial Policy
Download form
Health History
Download form
HIPAA Privacy Statement
Download form
Patient Demographics
Download form
Release of Medical Information
Download form