Forms
New Clinic Patient (click to print all)
  • New patient registration form
  • New patient history form
  • Privacy policy
  • Patient financial policy


Transfer Records

Day of Surgery Checklist
  • Shawnee Mission Main OR

  • Prairie Star Surgery Center
  • Shawnee Mission Surgery Center

These forms use Adobe PDF


dowload here
 
We hope you will spend some time organizing your thoughts with our forms:
"The majority of our patients print the forms online and have them filled out when they arrive.  When we get a referral from your doctors office we usually try to call you right away to set up the appointment and direct you to the website for forms."
                                                                                           - Toni



Printer not working?  That's ok just call.
If you would like us to mail to you our new patient forms we'd be glad to assist you -- please phone ahead.


(913) 432-4355  We will see you soon!
General and Laparoscopic Surgery
Prairie Surgical Care