Patient Forms

We look forward to taking great care of you.

Patient Forms and Resources

If you prefer not to use the electronic Patient Portal, you may download and complete selected forms by hand and return them to us via email, fax, or in person.

Patient Portal Guide
Preparing for Surgery (Preoperative Instructions)
After Surgery
Medical History Form
Financial and Privacy Policy Acknowledgement
Release of Medical Records
Privacy Practices
Non-Discrimination Policy

Information You Can Trust

Learn About Skin Cancer

Skin Cancer Support

See What Our Clients Are Saying

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Everyone was very nice to me. I would recommend the Surgery Center to anyone.

—Anonymous
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Just a brief note to express my satisfaction with the outcome of the surgery thus far. I appreciated you taking time out of your busy schedule to answer my questions. Also, I want to compliment your staff because they're so courteous whenever I call and they're so helpful. I recommended you highly to a friend who is now considering surgery on her face. She sees a doctor at UK but I said she should consider using your services. In short, I'm glad I put my face in your hands.

—CS
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Thanks for the advice you gave me to have the mole removed. I am thankful to God for the knowledge he has given you to know how to help people! Thanks again.

—JAC
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Thank you for all your help. I also wanted to compliment you on your kindness and great attention to detail. You always make time to talk and made me feel at ease through a tense procedure. I have been to many doctors in my life and would rate you as the best I have ever known. Your attentiveness, compassion, and ability are without any possible reproach. I can actually say I looked forward to my doctor visits rather than avoided them. I wish you continued success.  Thank you truly.

—TN
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The lovely ladies at the front desk could not be more accommodating.  They make you feel comfortable and they're so pleasant!  Your surgical assistant was so incredibly professional, but warm and friendly.

—JM
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Thank you for allowing me to observe your surgeries and 'talking shop' through the procedures for my benefit. Your sincere concern for your patients' comfort, as exhibited by your extraordinary bedside manner, truly sets a new, higher level for me to strive toward. I will strive for the highest mark, and I appreciate your example and training.

—TB, Medical Student
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I wanted to take this opportunity this opportunity to thank you all for taking care of me before, during, and after my Mohs surgery.  The customer service, compassion, and kindness of every single staff member was absolutely stellar and you should be incredibly proud of your dedication to the patient!

—MH (nurse practitioner)
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Thank you so very much for the tender care given me for my surgery, and to call to check on me was so very thoughtful and kind. To check on me the night of surgery and then the next morning!! Thank you so very much.

—JS
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Looking back on 2003, my family and I have faced many stressful and trying times traveling back and forth from doctor's office to office.  We are very fortunate to have such a caring doctor along with staff who are always willing to help in anyway possible. Thank you and your staff for not giving up and traveling down this long, hard road with me. You have always been straight up and honest with me and had my best interest in mind, not many doctors are like that and take things as personal.

—PE