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Surgery Center of South Central KansasSurgery Center of South Central Kansas

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Patient Forms

At Surgery Center of South Central Kansas, your time is as valuable to us as it is to you. Upon scheduling your surgery, a member of our staff will provide you with the required forms to fill out. We encourage you to take time to complete these before arriving on day of surgery, so that we may care for you promptly. If you happen to misplace any of the provided forms, duplicates are available for download and print below.

Patient Information Sheet

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Eye Surgery Patient Information

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Financial Agreement

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Notice of Privacy Practices 2013

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Patient Information

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Medication List

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Patient Rights and Notification of Physician Ownership

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Rate Your Pain

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Keeping You Safe During COVID-19 How to Prepare for Surgery Patient Forms Insurance and Billing Cataract Q&A Request an Appointment
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Surgery Center of South Central Kansas
1708 East 23rd Avenue,
Hutchinson, KS 67502

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