Patient Forms

At Surgery Center of Melbourne, your time is as valuable to us as it is to you. That’s why we provide online access to a variety of forms that patients may complete before their visit. The following documents will help us expedite the check-in process for your appointment. Please take a moment to download and print the appropriate form(s).

Patient Forms

Patient Rights Brochure (English)

Patient Rights Brochure (Spanish)

What do I need to bring the day of my procedure?

• Your insurance card(s).
• Driver’s License or Photo ID.
• A list of your current medications.
• A portion of your procedure payment.
• Leave valuables and jewelry at home.
• Wear comfortable, loose fitting clothes.
• Plan to be at the center from 90 minutes to two hours before your procedure time.
• If you’re younger than 18, you must have a parent or guardian accompany you to sign your paperwork. If you are an adult who is unable to sign the consent, you must have someone with you who is authorized to sign on your behalf.
• Bring the name and phone number of the person (must be 16 years or older with a valid driver’s license) who will be taking you home. You will not be permitted to drive, take a taxi alone or leave the center without an adult chaperone.