Patient Resources

Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, to accelerate your check-in process, we encourage you to:

Download the 5 ( 5) PDF Forms
Print and complete the forms
Forms can be emailed to our office email address info@surmecca.com

If you are unable to download our patient forms, then it is recommended that you arrive at your appointment 15 – 30 minutes early so you can have ample time to fill out the appropriate forms.

HIPPA Consent

Patient History

Authorization for Treatment

Patient Registration

No Show Policy

*Individual results are not guaranteed and may vary from person to person. Images may contain models.

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