Admissions Paperwork

The forms below will be available for you to sign when you check in for your surgery. However, if you would like to print and sign the forms prior to check in, please click on each link below to access the forms. An ASC staff member will need to review and sign them as well, so be sure to bring the forms with you should you decide to sign them ahead of time.

If you have any questions, please feel free to contact our Admissions Representatives at 850-916-8500.

Authorization for Release of Information to Family Members
Consent and Assignment of Benefits
Paradigm Anesthesia Assignment of Benefits
Advance Directives/Do Not Resuscitate Consent Form
Acknowledgment of Receipt of Privacy Notice – The Privacy Notice is available for your to read by clicking the link here: Privacy Notice