CALL US (312) 440-5150

60 E Delaware, 
15th Floor ​
Chicago, IL 60611​
60 E Delaware, 
15th Floor ​
Chicago, IL 60611​
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    • Your Visit
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    • Billing FAQs
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  • More
    • Home
    • About 900N
      • Surgery Center
      • Services
      • Anesthesia Services
      • Careers
    • For Patients
      • Your Visit
      • Forms
      • Patient FAQs
      • Pay Your Bill
      • Billing FAQs
      • ASC FAQs
      • Patient Testimonials
    • For Physicians
      • Why ASC?
      • Why 900N?
      • Credentialing
    • Location
    • Contact Us
  • Home
  • About 900N
    • Surgery Center
    • Services
    • Anesthesia Services
    • Careers
  • For Patients
    • Your Visit
    • Forms
    • Patient FAQs
    • Pay Your Bill
    • Billing FAQs
    • ASC FAQs
    • Patient Testimonials
  • For Physicians
    • Why ASC?
    • Why 900N?
    • Credentialing
  • Location
  • Contact Us

PATIENT RESOURCES IMPORTANT FORMS

Welcome to the 900N Michigan Surgical Center

 The information and documents you will find below will be supplied to you prior to your surgery in compliance with federal regulations.  Please read documentation pr carefully; upon checking in at the reception desk on the day of surgery you will be asked to sign an acknowledgement that you received this information. 

PATIENT RIGHTS AND RESPONSIBILITIES

Below you will find a copy of our “Patient’s Rights & Responsibilities.” We want you to be informed of these before your scheduled date of surgery/procedure. After you have read them carefully, please sign and date the document and bring it with you on the day of your procedure. 


Upon your arrival, the Front Desk Supervisor/Receptionist will ask you for this document. If you would like a copy to keep for your records, please let any of our staff know and we will provide one for you.

File coming soon.

For your convenience, we are also sharing notices and disclosures that you will be asked to acknowledge receiving upon admission.

Patient Notices and Disclosures

No Surprises Act Patient Disclosure 900N (pdf)Download

PATIENT SATISFACTION QUESTIONNAIRE

Our goal is to provide high quality medical care to our patients and their family members. That is why we invite your response to this questionnaire. With your help, our staff can evaluate how effectively we are meeting the challenge of providing you with quality care.

Your comments and response will be thoroughly reviewed and kept strictly confidential unless you specify otherwise. Thank you for your comments! 

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