Surgery Resources

INTAKE HISTORY FORM

Please fill this form to the best of your ability.

DEMOGRAPHICS FORM

FINANCIAL POLICY

Additional forms and documents that need to be reviewed

Advance-Beneficiary-Notice (pdf)

Benefits-Assignment (pdf)

Medical-Record-Release-Inbound (pdf)

Request-to-Amend-Medical-Record (pdf)

Surprise-Billing-Acknowledgment-Form (pdf)

Telehealth-Consent-Form (pdf)

No Show Policy (pdf)

Self Pay Price-List (pdf)

Financial Policy (pdf)

Resources

Downloads

Caregiving for a Loved One With Lung Cancer (pdf)

Lung Cancer Screening Brochure (pdf)

Breathe Easy Guide (pdf)

Immunotherapy for Lung Cancer (pdf)

Living With Lung Cancer (pdf)

Intake History Form (pdf)

Faqs About Health Plan (pdf)

Surprise-Billing-Acknowledgment-Form (pdf)

Surprise Billing Protection (pdf)