Patient Forms

Are you planning a visit to the Omaha Surgical Center? If so, please click on the links below to complete the forms. Thank you, and please call (402) 391-3333 if you have any questions.

Patient Registration Form

Patient Survey Form

Pre-Admission Form

Patient Rights Information English version

Patient Rights Information Spanish version

Non-Discrimination Form

HIPAA Privacy Form English

HIPAA Privacy Form Spanish

Pre-op Instructions Sheet

Surprise Billing

What You Need to Know About Your Appointment

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Pre-admission Interview

Once you are scheduled for surgery at the Omaha Surgical Center, you will receive a phone call for a pre-operative admission interview. Our pre-op staff member will answer your questions about preparing for surgery and ask you to provide a brief medical history and information about medications or allergies. During the call, your arrival time to the facility will be provided along with any other pre-op instructions.
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Insurance Card & Photo Identification

Please remember to bring your insurance card and photo ID with you on the day of your surgery for check-in.
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Bring a Companion

Please bring someone with you on the day of your surgery that can help in getting you home after your procedure. A companion can be with you before and after surgery and you will need a ride home. In addition, you will receive verbal and written instructions of how to care for yourself after surgery. A nurse from the Omaha Surgical Center will contact you the day after your surgery to see how you are feeling and to answer any questions you may have.
“Omaha Surgical Center’s staff treated us wonderfully! We felt comfortable and well informed. Omaha Surgical Center is the best! ”

Wes R.

Patient

Excellence in Outpatient Surgery

cservice@omahasurgicalcenter.net

(402) 391-3333

8051 West Center Road