Pre-Surgery Registration Form

An HCF Management Inc. Community

HCF Family of Companies comply with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. English ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-866-453-7413 xxx 45805 Spanish ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-453-7413 xxx 45805 Chinese注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-866-453-7413 xxx 45805