Forms

Welcome to Providence Surgical Associates. We look forward to your visit!

New Patient Forms

We are updating our patient forms. Please arrive early to your appointment to fill out our forms onsite. 

Please complete the following steps for your first visit:

  1. Send us your previous medical records, lab results, or immunization records.
  2. Arrive 30 minutes early.
  3. Bring your regular over-the-counter and prescription medications.
  4. Bring your insurance card(s)
  5. Bring a photo ID (Federal Regulations require this)

All patients are responsible for co-pays, deductibles, co-insurance and charges for services rendered at the time of the appointment. Patients without insurance cards are considered Self Pay. We accept cash,check and credit cards.

If you are more than 15 minutes late to your appointment, you may be asked to reschedule.

Contact us with any questions or concerns. Thank you for your cooperation.