On behalf of the staff and physicians of Jefferson Ambulatory Surgery Center we would like to welcome you to our facility and share with you our total commitment to providing exceptional, safe patient care, and compassionate service to all our patients and their families. We look forward to meeting you and exceeding your expectations in providing your outpatient surgical needs.
In order to expedite the paperwork process upon your arrival please complete the following documents: Patient Information Sheet, Anesthesia Questionnaire, and Pain Management Medication Sheet. We ask that you bring these three completed forms with you on the date of your pain management procedure along with your driver’s license or photo I.D. and insurance cards.
A representative from the facility will contact you the day before your procedure to provide you with your arrival time. The representative will also inform you if you are responsible for a surgical co-pay or deposit for your procedure.