Forms
We are providing you with copies of the three forms you will need to complete for registration. Please print them out, complete them and fax them or bring them with you to your pre-operative visit.
We have also included the pre-operative instruction sheet for your review. You can print this out also and bring with you for your pre-operative visit.
Bellingham Surgery Center Patient Registration Form (PDF)
Health Status Questionnaire (PDF)
Medication Reconciliation Form (PDF)
Pre-Op Instructions (PDF)
We are participating in a nation-wide safety program sponsored by the Joint Commission because we value your safety. This program encourages patients to Speak Up (English).
Speak Up (Hindi)
Speak Up (Russian)
Speak Up (Spanish)
Speak Up (Vietnamese)
Patients Rights & Responsibilities
Patient's Rights and Responsibilities (English)
Patient's Rights and Responsibilities (Russian)
Patient's Rights and Responsibilities (Hindi)
Patient's Rights and Responsibilities (Vietnamese)
Patient's Rights and Responsibilities (Spanish)