Recall Procedure Paperwork

Complete only if you received a recall notice from the office. Please fill these forms out online or complete the forms you've received in the mail to begin the scheduling process. It is equally important that we receive a copy of your insurance card before we schedule your appointment/procedure. Please email a copy of your insurance card (front and back) to scheduling@fxcrs.com.

Forms to complete

• Medical History Form
• Registration Form
• Scheduling Preference Form

Office Policy Forms to read

• Office Policies (PDF of all policies)
• Surgical Center Policies (PDF)
• Office Visit Policies (PDF)
• Privacy Form (HIPAA) (PDF)
• Patient Bill of Rights and Responsibilities (PDF)
• Consent for E-mail correspondence and Electronic Communication (PDF)