Patient Forms
Advance Directives
Advance Directives are documents that allow you to state your wishes about medical care in the even that you are unable to speak for yourself.
DownloadGrievances
The patient has the right to voice complaints about their care and to have those complaints reviewed and, when possible, resolved.
DownloadPatient Guide to Surgery
It is important for you to follow the below guidelines before surgery in order to avoid delay or cancellation on the day of your procedure.
DownloadMedical Records Release Forms
Authorization to Request Protected Health or Billing Information
DownloadCharity Care Policy
Matthews Surgery Center (MSC) will provide charity care (free care) for qualified low- income patients for medically necessary procedures.
DownloadPatient Rights & Responsibilities
Download the Matthews Surgery Center patient bill of rights & patient responsbilities.
DownloadNotice of Privacy Practices
This notice describes how health information about you may be used and disclosed and how you can get access to this information
Download
