Pre-Registration

Forms to Prepare for Your Appointment

Thank you for choosing Ashland Surgery Center for your upcoming procedure or surgery. We look forward to seeing you.

To make your surgery day as smooth as possible, please print and complete the registration forms linked to on this page. When you arrive on your surgery day, please bring the following:

Your insurance card(s)
Photo ID
Completed registration forms

Our registration staff will review your registration forms with you and verify your insurance information. If you have a co-pay or balance, you will be asked to pay it at registration.

Ashland Surgery Center is committed to ensuring your safety. During the registration and surgery preparation, staff members will ask you to identify yourself and verify your planned procedure. It can seem tedious, but please be patient and remember we are doing this to ensure your safety, which is always our top priority.

Patient Resources

The following forms should be completed before your scheduled procedure. (Click on each item to download a printable form.)

Ashland Surgery Center (ASC) is owned by five local physicians: Dr. Chow, Dr. Ewing, Dr. Fredrickson, Dr. Schiedler, Dr. Welder, and Dr. Herron, who also perform procedures at ASC. If you have any questions or wish to have your procedure at another facility, please get in touch with your physician. Other physicians providing services at the center are independent providers of medical services and are not employees or agents of ASC. Questions about your treatment plan or charges billed by your surgeon or anesthesia provider should be directed to their offices. Thank you for choosing ASC.