Patient Information

Welcome to the Southwest Surgical Suites Patient Information portal! You’ll likely have questions before, during, and after your procedure. Here you will find all the details, from what to wear to what to avoid in the hours leading up to your visit, all part of our goal of making you as relaxed and comfortable as possible.


These forms are required for your upcoming procedure. Please download, print, and fill out these forms, and mail them to our office 1 week before your procedure. This will help expedite the patient intake procedure and give you more time to completely fill out the information.

Patient History (PDF)
Medications (PDF)

The following forms are for your information only and do not need to be printed or returned:

Patient Rights (PDF)
Advance Directives (PDF)


Payment and Insurance

Patient Billing and Payment Information (PDF)

At Southwest Surgical Suites, we do everything we can to make your payment or billing process easy and as smooth as possible.

Payment is due at the time of service. You are responsible for any copays, co-insurance or deductibles as indicated by your health insurance, and we will file a claim with your insurance company. For your convenience, we accept Visa, MasterCard, Discover Card, or debit card.

If you have questions about your bill, please contact our office at 260-434-2022.


“World Class Facility! A staff that is outstanding in every respect. Many thanks!”