We have provided some of the patient forms you may need for your surgical center appointment. For the protection of your information, these forms cannot be filled out online at this time, but you can download the form and fax it back to us on the secure fax line 310-574-0441

Pre-Admission Forms

• Patient Registration
• HIPAA Privacy Policy
• Release of Medical Information
• Medical Reconciliation
• Patient rights and responsibilities

General Forms

• Physician Ownership Disclosure
• DISC policy on Advanced Directives(English)
• DISC policy on Advanced Directives(Spanish)
• Advance Directive Forms(English)
• Advance Directive Forms (Spanish)
• Patient Post-Operative information
• Patient satisfaction form (English)
• Patient satisfaction form (Spanish)
• DISC policy and procedure for Complaint management