Surgeons On Demand

Patient Guide

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Map & Driving Directions

Atlas Diagnostic Imaging

5023 N. Illinois St. Fairview Heights, IL 62208
Phone: 618-239-0678

Apollo Ambulatory Surgery Center

10012 Manchester Rd, St. Louis, MO 63122
Phone: (314) 462-9100

Physicians' Surgical Centre

311 W Lincoln St # 300, Belleville, IL 62220
Phone: (618) 239-0678

Metroeast Endoscopic Surgery Center

5023 N Illinois St, Fairview Heights, IL 62208
Phone: (618) 239-0678

Belleville Surgery Center

28 N 64th St, Belleville, IL 62223
Phone: (618) 239-0678

O'Fallon Surgical Centre

741 Insight Avenue O’Fallon, IL 62269
Phone: (618) 239-0678

Elite Ambulatory Surgery Center

10012 Manchester Rd, St. Louis, MO 63122
Phone: (314) 462-9113

Advanced Orthospine Institute

10012 Manchester Rd, St. Louis, MO 63122
Phone: (314) 462-9100

Interventional Pain & Spine Institute

28 N 64th St, Belleville, IL 62223
Phone: 618-239-0678

Patients Form

Patient’s Rights

Your Rights

  1. Considerate, respectful care at all times and under all circumstances with recognition of your personal dignity.
  2. Personal and informational privacy within the law.
  3. Be fully informed about your diagnosis, treatment, and prognosis to the degree known.
  4. Confidentiality of records and disclosures. Except when required by law, you have the right to approve or refuse the release of records.
  5. The opportunity to participate in decisions involving your health care, including the right to accept or refuse medical or surgical treatment, unless contraindicated by concerns for your health.
  6. Change primary or specialty physician or dentist if others are available.
  7. Information concerning implementation of any advance care directive.
  8. Impartial access to treatment regardless of race, color, sex, national origin, religion, handicap or disability. (The Surgery Center adheres to all Federal and State rules, regulations, and policies to promote a safe and non-discriminatory environment for all of our guests).
  9. Request information on fees for services or payment policies and receive a bill for services upon request.
  10. Know the identity and professional status of individuals providing service to you.
  11. Report any comments concerning the quality of services provided to you during the time spent at the facility and receive fair follow-up on your comments, complaints or grievances without discrimination or reprisal.
  12. If adjudged incompetent under applicable state health and safety laws by a court of proper jurisdiction, your rights will be exercised by the person appointed under state law to act on your behalf.
  13. If not adjudged incompetent, any legal representative or surrogate designated by you in accordance with state laws may exercise your rights to the extent allowed by state law.
  14. Exercise any and all of these rights without being subjected to discrimination or reprisal.

Your Responsibilities

  1. Providing accurate and complete information about your current health status and past medical history to the best of your knowledge, and reporting any unexpected changes to the relevant practitioner (s).
  2. Adhering to the treatment plan indicated by the primary care physician in your instance.
  3. Providing an adult to drive you home following surgery and to be responsible for you at home for the first twenty-four (24) hours.
  4. Indicating whether you clearly understand a contemplated course of action and what is expected of you.
  5. Your actions if you refuse treatment, leave the facility against the advice of the practitioner, and/or do not follow the practitioner’s instructions relating to your case.
  6. Assuring that the financial obligations of your health care are fulfilled as expediently as possible.
  7. Providing information about and/or copies of any living will, power of attorney or other directives that you desire us to know about.
  8. Being respectful of all healthcare providers and staff as well as other patients.