Our Mission:

 

To provide the patient community with a premier medical facility that is conveniently located and offers a comfortable and safe surgical and recovery environment.

BERGENFIELD SURGICAL CENTER, LLC

 

Patient Forms

 

 

All Patient Forms are in PDF format and require Adobe Acrobat Reader to view or print. If you do not have

Adobe Reader installed on your computer, you can get it free by clicking here.

 

 

Click on any form to view:

 

 

Online Pre-Registration

 

HIPAA Notice of Privacy Practices

 

HIPAA Notice of Privacy Practices (en Espanol)

 

Patient Rights and Responsibilities

 

Patient Rights and Responsibilities (en Espanol)

 

Advanced Directive

 

Advanced Directive - Living Will

 

Please Take Our Patient Satisfaction Survey

 

 

 

201.374.2829

Bergenfield Surgical Center, LLC

1 North Washington Avenue, Suite A

Bergenfield, NJ 07621

201.374.2829

 

© 2014 Bergenfield Surgical Center, LLC