Ormond Beach, Palm Coast, and Port Orange - Call any of our offices at:(386) 672-4244

Tomoka Surgery Center Patient Forms

Tomoka Surgery Center Patient Forms 2018-05-17T00:03:44+00:00
If you are a new patient, please fill out the forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment.
Registration Forms
•    Registration/HIPAA communication form
•    Advance Directives
Patient Rights & Responsibilities
This document will explain your patient rights and responsibilities.  It is part of your patient registration and is an important part of your health care plan.
•    Patient Rights & Responsibilities
Privacy Notices
This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
•    Notice of Privacy Practices (provided for you at your first visit)

Tomoka Surgery Center
345 Clyde Morris Blvd Ste 300
Ormond Beach , FL 34984
Phone: 386-672-7575
Fax: 386-677-2770