Vernon Square Surgicenter

Medical Clearance Information

Surgical Patient Information

Cataract Patient Information

Medical Clearance Forms

Forms To Bring On The Day Of Surgery

Medical History Questionnaire

Insurance Financial Consent

Self Pay Financial Consent

If you would like to complete your forms online through our secure site prior to your day of surgery, you will need your patient ID and social security number, and use this link:

Vernon Square Surgicenter

Patient Information

Advance Directive

Privacy Practices

Patient Rights and Responsibilities