-
Admission Form
Complete Form
-
Pre-Operative Instructions
View Instructions
-
Protections Against Surprise Billing
View Notice
-
Notice of Patient Privacy
Download PDF
-
Notice to Self Pay Patients
View Notice
FAQs
When is the last time I can have something to eat or drink prior to my procedure?
8 hours prior to procedure.
What medications should I take prior to my procedure?
Please take any blood pressure, seizure or cardiac/heart medications with a sip of water prior to coming into the facility on the day of the procedure. If you are on aspirin or any blood thinners or are a diabetic, please ask your doctor's office when to take the last dose.
Should someone come with me on the day of my procedure?
Yes, although if no one is available to come with you, please make arrangements to have a responsible adult at home afterward.
What should I bring with me on the day of my procedure?
Please leave all valuables and remove all jewelry. Please bring your insurance card and photo ID with you.
Who should I contact for a cost consultation?
Patients should contact their insurance carrier for any questions or concerns about benefits and additional costs.
Are physician fees included in facility fee?
Physician fees are not included in facility fee.
How does physician plan participation and benefits work?
Physicians who provide services in the facility may or may not participate with the same health benefits plans as the facility. Patients should check with the physician arranging for the facility services to determine the health benefits plans in which the physician participates in.
Pleasantdale Ambulatory Care utilizes the New Jersey Immunization System (NJIIS) to verify COVID-19 vaccination history.
