Patient Forms

You have certain rights and responsibilities as a patient. We have posted this document so you can learn what these are.  You will sign this form on the day of surgery or at your pre-operative interview. It is not necessary for you bring a copy with you on the day of your surgery. We provide this online for your convenience.

Patient Rights & Responsibilities (PDF download, will open in new window)

Pre-Operative Instructions
These are general pre-operative instructions that the nurse will review with you during your pre-operative interview.

Patient Satisfaction Survey

This is our satisfaction survey.  It is our primary means of measuring your level of satisfaction with HOSC.  If  you lose or misplace the one we give to you, it is here for your convenience.

HOSC Privacy Practices
This is our Notice of Privacy Practices.  This impacts you as a patient and we are required to notify you of them.

Living Will (offsite link to information about living wills)
We are required by Medicare to notify you of our policy concerning Advanced Directives and Living Wills.  Because we are an ambulatory surgery center performing elective surgeries, HOSC recommends that you waive the use of any Living Wills or Power of Attorney documents that you currently have executed.  Learn more at lmhpco.org.

Post-Op Instructions

Drain care instructions
Carefully follow the instructions for drain care and record drained fluid on this form.

Post-Op: Dr. Contreary
Post-Operative Instructions for patients of Dr. Contreary

Post-Op: Dr. Lindsey
Post-Operative Instructions for patients of Dr. Lindsey

Post-Op: Dr. Khoobehi
Post-Operative Instructions for patients of Dr. Khoobehi

Post-Op: Dr. Massiha
Post-Operative Instructions for patients of Dr. Massiha

Post-Op: Dr. Metzinger
Post-Operative Instructions for patients of Dr. Metzinger

Post-Op: Dr’s. McCarthy, Griffin & Mayfield
Post-Operative Instructions for patients of Dr. McCarthy, Dr. Griffin, and Dr. Mayfield

Post-Op: Dr. Sadeghi
Post-Operative Instructions for patients of Dr. Sadeghi