Patient Forms

HIPAA Form

Medical Questionaaire (Treatment Room)

Medical Questionnaire

Pediatric Questionnaire

Patient Bill of Rights

If you have questions, be sure to check out Frequently Asked Questions or call us at the number below.

 
Ambulatory Surgery Center of Western New York
945 Sweet Home Road • Amherst, NY 14226
Office: 716-831-9435
Fax: 716-831-9475
Click here for a map and directions.

 
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