Forms To Prepare you for Surgery at La Peer

LaPeer Forms

Welcome to the part of our website where you will find the relevant forms and applications that you may need in order to carry out your treatment here at LaPeer Surgery Center. It is very important that before you go ahead with any treatment, you have details of your health insurance and any other relevant details available for staff at the center to see. These may not be necessary for a preliminary check up or consultation, but we advise that you try and have these to hand when you visit. This is to make the process of registration as smooth and a fast for you as possible.

You may wish to take a look at some of these forms, print them and fill them out before your next appointment if there is a particular treatment that you would like carried out. For instance, to request an x-ray you simply need to download, print and fill out the relevant form before you visit the center. You can either bring it with you to hand in, or send it to us in advance so that we can arrange for the procedure to be carried out in a timely fashion. Sending completed forms to us in advance will always speed up your treatment and registration.

 PDF File Medicare Required Paperwork
 PDF File Patient History
 PDF File Billing Reminders and Contacts Forms
 PDF File Privacy Noticed Revised

If at any time you require assistance with filling out any forms, or you require further information on any of the preliminary registration procedures then please do not hesitate to contact us. You can call a member of our staff at (855) 360-9119 or alternatively write to us about your condition or treatment at:

La Peer Health Systems
(855) 360-9119
8920 Wilshire Blvd #101
Beverly Hills, CA 90211
[email protected]