Patient Forms

We look forward to taking great care of you.

Patient Forms and Resources

If you prefer not to use the electronic Patient Portal, you may download and complete selected forms by hand and return them to us via email, fax, or in person.

Patient Portal Guide
Preparing for Surgery (Preoperative Instructions)
After Surgery
Medical History Form
Financial and Privacy Policy Acknowledgement
Release of Medical Records
Privacy Practices
Non-Discrimination Policy

Information You Can Trust

Learn About Skin Cancer

Skin Cancer Support

See What Our Clients Are Saying

quote icon

Thank you all for your care and expertise during our recent skin surgeries. Everything was really appreciated for our speedy recoveries.

—J&AE
quote icon

Everyone was very nice to me. I would recommend the Surgery Center to anyone.

—Anonymous
quote icon

It is a miracle to look at Gordon and not see the large, red, and very irritating sores that were there. Dr. Dhir did the surgeries…I thank God and Dr. Dhir and his assistants for their most patient, kind, and loving treatment of Gordon. He is a special person and I know God has helped us to get this far with his recovery from a most dramatic period in his life.

—The Central Record (newspaper column), October 26, 2006
quote icon

I am truly blessed to have you in my life. Thank you so much for your special attention.

—AS
quote icon

I just wanted to thank you for taking such good care of my mother through two separate procedures. You have a kind and calming manner that is very rare today in the medical field, especially with the elderly, the ones that need it the most. And it is very much appreciated. Thank you again. May God bless you and your family.

—DB
quote icon

Just a brief note to express my satisfaction with the outcome of the surgery thus far. I appreciated you taking time out of your busy schedule to answer my questions. Also, I want to compliment your staff because they're so courteous whenever I call and they're so helpful. I recommended you highly to a friend who is now considering surgery on her face. She sees a doctor at UK but I said she should consider using your services. In short, I'm glad I put my face in your hands.

—CS
quote icon

quote icon

Thank you for taking patience with me and my hard of hearing problem. I also like your manner of "doctor to patient" attitude. I appreciate all you did and your patience with me. I know it's hard to talk to a person 88 years old and particularly nearly deaf but both me and my daughter appreciate your patience and service. If I have a problem, I'll see you and know it will be taken care of.

—BS
quote icon

Thank you so much for sharing your talents with me the last couple of years. You have been so kind and you can't imagine what a difference you have made in my life. You are a wonderful doctor!

—PB
quote icon

Just a note to thank you for being so diligent in your pursuit of skin cancer. Because you caution 'on the safe side', you were able to detect my basal cell (carcinoma) very early. I also want to thank you for referring me to Dr.  Dhir. He was a dear! Thanks again for your care!

—ME