Patient Information & Forms
Thank you for trusting your care to your physician and The Surgery Center of Chester County in Exton, Pennsylvania. Please bring these completed forms with you to the surgery center on the day of your surgery.
- Patient History & Preoperative Questionnaire
- Pre-Surgery Information
- Patient Instructions
- Patient Satisfaction Questionnaire
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
If you have a surgery scheduled with us, please take a few moments to read the following:
A nurse from the Surgery Center of Chester County will contact you on the last business day before your scheduled surgery day and give you your pre-surgery instructions and a time to report to the surgery center. If you are not at home at the time of the call, a message will be left on the voicemail associated with the phone number you provided.
There are four main types of anesthesia:
- General Anesthesia – affects the entire body.
- Regional Anesthesia – affects a section of the body, such as an arm or everything below the waist. In addition to regional anesthetic, you may be given medication to relax you or help you sleep.
- Local Sedation – a twilight or deep sedation done through an IV.
- Local Anesthesia – affects only the area involved in the procedure.
If you are receiving general anesthesia, regional anesthesia, or local sedation:
- Do not eat or drink anything, including gum or hard candy, after midnight prior to your surgery. Any stomach contents are potentially dangerous.
- Do not come alone. A companion may stay with you before and after surgery.
- Do not drive your car home. You must have a ride.
If you are receiving local anesthesia, there are no restrictions and you may eat or drink prior to the procedure, as well as drive yourself to and from the surgery center if you like.
Leave all jewelry and valuables at home. Wear loose-fitting clothing. Gowns and slippers will be available at the surgery center. Do not wear eye makeup.
Arrive at the surgery center at the time instructed – the extra time is necessary for admission procedures.
After your surgery, you will be taken to the recovery room. There, you will receive constant care by a registered nurse until you are awake. During this time, your nurse will provide you with post-op self-care instructions. By carefully adhering to them, you will greatly speed up your return to normal activity. Just before you leave the surgery center, your nurse will make sure all is well and give you a chance to ask last-minute questions. Then, you will dress and be escorted to the car and return home.
The next day, our registered nurse will telephone you to check on your condition and assist with any questions. In the event of a medical/surgical emergency, you may need to be admitted to an area hospital.
For any follow-up appointments and/or post-op questions, please call your physician’s office directly.
Please bring your insurance care and a photo ID with you. If it is a workers’ comp or car accident injury, please bring all information needed (insurance name, address, phone, claim number, date of injury, etc.), so we can submit the correct information. However, the responsibility for the payment rests with the patient, should your insurance company deny coverage. Failure to provide the necessary documents as stated above will result in The Surgery Center of Chester County canceling your procedure.
Most insurance companies reimburse the surgery center for surgical care. Every attempt is made to verify each patient’s insurance coverage in advance to accurately inform the patient of any cost to them.
Deductibles, co-pays, and any portions not covered by your insurance must be paid at the time of service. Charges for cosmetic surgery and for those without insurance must be paid at the time of service. Failure to pay could result in cancelation of your procedure. Acceptable forms of payment include cash and most major credit cards, including American Express, Visa, Mastercard, and Discover. Prior financial arrangements can be made by calling (610) 594-8900.
Surgery center fees are based on procedures performed by your physician. Not included in the standard fee is the charge for the professional services of your surgeon, the anesthesiologist, and any pathology studies. Also not included are any implants or hardware that are billed separately. So, in addition to being responsible for bills from your physician, you may also be responsible for out-of-pocket expenses from:
- Your surgeon’s office
- The Surgery Center of Chester County, (610) 594-8900: co-pays, co-insurance, deductibles – which are all due at the time of your procedure.
- Associates in Anesthesia, (610) 874-6448
- CBL Path, (855) 725-6444: pathology processing
All three businesses bill separately and are independent of your physician’s office.