Patient Resources

Palms Wellington Surgical Center looks forward to having you join our family of satisfied patients. Once your surgery has been scheduled, please complete and submit the pre-surgery health screening form online as soon as possible.

To expedite the check-in process, please download all of the following forms, complete them, and bring them with you to the surgery center when you arrive for your procedure. Be sure to bring your insurance card and identification as well.

Online Forms

Pre-Surgery Health Screening Form

Downloadable Forms and Information

Patient Information Form (English)

Patient Information Form (Spanish)

Pre-Procedure Instructions

Patient rights and responsibilities:

• Patient Bill of Rights (pdf) (English & Spanish)

Notice Of Privacy Policies:

• Notice Of Privacy Policies (pdf) (English)
• Notice Of Privacy Policies (pdf) (Spanish)

Disclosure of physician financial interest in the surgical center:

• Notice of Disclosure of Ownership Interests (pdf) (English)
• Notice of Disclosure of Ownership Interests (pdf) (Spanish)

Advance directive information:

• Healthcare Advance Directives (pdf) (English)
• Healthcare Advance Directives (pdf) (Spanish)

Safety and Recalls

• FDA and CDC Notice
• Florida Department of Health Online Newsroom
• FDA Safety Recalls

Additional Patient Resources

• Pre-Procedure Instructions
• Day of Surgery Instructions
• After Surgery Instructions
• Insurance Information
• Non-Discrimination Policy
  

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.