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Forms & Policies

Patient Forms History and Physical Form Admission and Financial Notice Documents Acknowledgment Fax Cover Sheet Health Care Surrogate for Minor Policies Patient Rights and Responsibilities Notice of Privacy Practices Advanced Directive No Surprises Act

New Patient Forms

New Patient Forms Coming Soon! Advance Directive Form Admission & Financial Notice For Patient Form Notice To Patient Form surgery center referral Form Surprise Medical Bills Form

Billing & Insurance

Billing & Insurance Information Lakeside Dental Surgery Center is a brand-new surgery center, and we are in the process of credentialing with every major medical insurance provider, including Tricare and Florida Medicaid. Our facility is a medical facility, which means your family is able to use its medical insurance for the anesthesia services provided by …

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A referral is required from your dentist or physician.