Notice of Privacy Practices
I have received written and verbal notification regarding Center for Advanced Surgery privacy practices and my Patient Rights prior to my surgery/ procedure. I have also received information regarding policies pertaining to Advance Directives prior to my procedure. This facility does not provide implementation of advanced directives; on the basis of conscience (the scheduled procedure is an elective procedure), regardless of the contents of any advanced directives or instructions from a health care surrogate or attorney. If an adverse event occurs at this facility, we will initiate resuscitative or other stabilizing measures and transfer patient to an acute care hospital for further evaluation. The receiving hospital will implement further treatment or withdraw of treatment measures already begun in accordance with patient wishes, advance directives or health care power of attorney.