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Below you will find a copy of our “Patient’s Rights & Responsibilities”. We want you to be informed of these before your scheduled date of surgery/procedure. After you have read them carefully, please sign and date the document and bring it with you on the day of your procedure. Upon your arrival, the Front Desk Supervisor/Receptionist will ask you for this document. If you would like a copy to keep for your records, please let any of our staff know and we will provide one for you.
To save time and make your admission smoother, you can download and fill out some of the forms prior to your visit at The 900 N Michigan Surgical Center. Below you will find some of the standard documents we will ask you to fill out prior to your admission.
Notice of Privacy Practices
Patient Rights and Responsibilities Acknowledgment Form
Patient History Form
Surgery Scheduling Request Form
Patient Satisfaction Questionnaire
900 North Michigan Surgical Center Brochure
Directions to 900 North Michigan Surgical Center
900 North Michigan Surgical Center JCAHO Certificate
Our goal is to provide high quality medical care to our patients and their family members. That is why we invite your response to this questionnaire. With your help, our staff can evaluate how effectively we are meeting the challenge of providing you with quality care.
Your comments and response will be thoroughly reviewed and kept strictly confidential unless you specify otherwise. Thank you for your comments!
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60 E Delaware 15th Floor Chicago IL 60611 US