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Physicians Surgical Center of Lebanon

Physicians Surgical Center of Lebanon

1840 Quentin Road Lebanon, PA 17042

Phone: (717) 272-0007

Fax: (847) 257-8377

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Patient Forms

General Forms

  • File
    Allergy Notice
  • File
    Physician Ownership List
  • File
    Patient Health History
  • File
    Non Discrimination Notice (English)
  • File
    Advanced Directives (English)
  • File
    Non Discrimination Notice (Spanish)
  • File
    Medication Reconciliation List
  • File
    Patient Rights & Responsibilities
  • File
    Privacy Notice (English)
  • File
    Privacy Notice (Spanish)
  • File
    Post Op Reference Sheet - English
  • File
    Post Op Reference Sheet - Spanish
  • File
    Right to Receive a Good Faith Estimate of Expected Charges
  • File
    Notice Regarding Patient Protections Against Surprise Billing
  • File
    Instrucción anticipada de atención de salud (Español)

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Physicians Surgical Center of Lebanon

1840 Quentin Road Lebanon,  PA 17042 Phone: (717) 272-0007 Fax: (847) 257-8377
Surgery Partners
We Operate Differently.