Our Patient Center

If not already provided by your surgeon’s office, please print out the necessary forms on this page prior to your surgery. This will ensure that we have the necessary information to provide you with the utmost quality of care. To print, click the download button, print, fill out, and bring it with you on the day of your surgery. We look forward to seeing you.

Advanced Directives

If applicable, please bring a copy of your advanced directive to your surgery. If you would like a blank advanced directive, please download the PDF below. This is not required for your surgery.

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Notices and Disclosures

Please download the Notices and Disclosures pdf below.

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Notice of Privacy Practices

Please download the Notice of Privacy Practices pdf below.

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Patient Guide

Please download the Patient Guide pdf below.

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Patients Rights

Please download the Patient Rights pdf below.

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Authorization for Treatment

Please download the Authorization for Treatment pdf below.

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Authorization to release Protected Health Information

Please download the Authorization to release Protected Health Information pdf below.

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Notice to: Driver/Caregiver

To ensure a smooth transition from post-operative care to home we have outlined the following requirements:

Please remain within the Lewes Surgery Center parking lot.

Please verify your phone ringer is on.

We will ask you to pull up to the front door where you will be given patient discharge instructions. Please wear a mask while reviewing the instructions with our nursing staff.

If you must leave, it is LSC protocol to remain within 1 mile of the center and be readily available by the contact phone number provided. If this cannot be accommodated, please ensure our staff is notified in advance.

If you are not staying to provide transportation home and another driver/caregiver is to be picking the patient up, please notify front desk staff in advance.

We appreciate your cooperation.

Please print, fill out, and bring the below PDF to your surgery.

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Surprise Medical Bills Notice

Please download the Surprise Medical Bills Notice pdf below.

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