Planning your visit  to
Commonwealth Surgical Associates

When you schedule your initial appointment with one of our Surgeons or our Nurse Practitioner, you may receive a welcome packet, including forms, to be completed prior to your visit. We look forward to making your initial encounter as pleasant and convenient as possible.

You may download any of the forms from our website immediately and start to complete them.

Patient registration form

Medical and surgical history form

Medication log and allergy list

If you leave filing out the forms until you come to see us, you may significantly delay your appointment and to avoid delaying other patients too, rescheduling  your appointment may be necessary.
 

If you are coming for an initial visit for breast disease you will need to fill out the breast problem history form as well. If this is your first visit for weight loss surgery, the weight loss surgery inital patient assessment form must be completed prior to your visit.

You will be contacted in advance of your visit to confirm the date, place and time of the appointment. We request you bring with you a list of your current medications including the name, strength, dosage and how often you take each prescription.

When you are completing the medical history forms, please pay special attention to the history form as well as the medication log and allergy list that includes a section about allergy to medications. This essential information will become a part of your record here.

If you have had recent tests associated with the current problem for which we are seeing you, please arrange with the office staff to obtain copies of your written test results. They may, at the time you discuss those test results, ask you to bring films of studies performed. The staff will be happy to work with you to facilitate that process.

We participate with most every managed care insurance plan. Should your particular plan require referral when you visit our specialists, you must contact your primary care physician, let that physician know when you will be coming to our office, and request a referral. Some referrals are transmitted to us by your physician electronically. Some may be mailed and some may require you to pick up the paper referral and bring it with you to your appointment. In the absence of your referral, we will be happy to provide care; however, your insurance may not be responsible for our charges, and you will be required to sign a waiver assuming responsibility for payment.