Here at Palms Wellington Surgical Center, we understand that preparing for and undergoing surgery can be a demanding time. Once you have scheduled your surgery or procedure, and to help make the paperwork process as smooth as possible, we have provided all the necessary forms you will need to complete prior to your surgical appointment in one convenient location.
We have provided you with both interactive forms and downloadable PDF forms for your convenience. If you do not wish to complete the online, interactive forms, you may download, print, and complete the PDF forms instead. Please be sure to bring the completed forms with you on the day of your surgery or procedure as completing the forms prior to that day will help speed up your registration process.
Pre-Surgery Interactive Forms
English:
- Patient Information Form
- Financial Agreement Form
- Patient Authorization to Use or Disclose PHI
- POA and Medical Release Form
- Consent to Resuscitate
- Race Form
- Patient Information Form
- Financial Agreement Form
- Patient Authorization to Use or Disclose PHI
- POA and Medical Release Form
- Consent to Resuscitate
- Race Form
Pre-Surgery Forms (PDF)
English:
- Patient Information Form
- Patient Bill of Rights
- Notice of Privacy Policies
- Notice of Disclosure of Ownership Interests
- Health Advance Directives
- Financial Agreement Form
- Patient Authorization to Use or Disclose PHI
- POA Disclosure and Acknowledgement Form
- Consent to Resuscitate
- Race Form
Spanish:
- Patient Information Form
- Patient Bill of Rights
- Notice of Privacy Policies
- Notice of Disclosure of Ownership Interests
- Health Advance Directives
- Financial Agreement Form
- Patient Authorization to Use or Disclose PHI
- POA Disclosure and Acknowledgement Form
- Consent to Resuscitate
- Race Form
Need Help?
Should you have any questions related to the forms or how to fill them out, please contact our representatives at Palms Wellington Surgical Center in Royal Palm Beach, Florida at (561) 792-7333.
