Downloadable Forms

Here you can find all of the forms you need to get started with Memorial and Katy Surgical Specialists. Just download the attachments you’re looking for.

General Forms

HIPAA Authorization to Release Records >>
HIPAA Authorization for the Disclosure of Protected Health Information.

HIPAA Authorization to Disclose Information >>
HIPAA Authorization of Use and Disclosure of Protected Health Information.

Policies and Notices

Notice of Privacy Practices >>
(Memorial and Katy Surgical Specialists Notice of Privacy Practices.)

Financial Policy >>
(Financial policy for Memorial and Katy Surgical Specialists.)

New Patients