407.354.5401 Driving Directions ▸ Before Surgery Day of Surgery After Surgery Patient Forms HOME PHYSICIANS FOR PATIENTS DIRECTIONS CONTACT PATIENT FORMS Authorizations & Disclosures Patient Rights & Responsibilities Assignment of Benefits Notice of Privacy Practice Cigna DOR (Only to be filled out by patients who are insured by Cigna” & Only to be filled out by patients who are insured by UHC) Out of Network Authorization Form UHC Member Transportation Release Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon. Advanced Surgery Center of Orlando, LLC 6900 Turkey Lake Rd Ste 2-5 Orlando, FL 32819 Fax: 407-354-5403 © Copyright 2021 Advanced Surgery Center of Orlando. All rights reserved. Site design by WDS. Contact Home

407.354.5401 Driving Directions ▸ Before Surgery Day of Surgery After Surgery Patient Forms HOME PHYSICIANS FOR PATIENTS DIRECTIONS CONTACT AFTER SURGERY You will be discharged to your car by wheelchair. If anesthesia has been administered, you must have a responsible adult present to drive you home and to care for you following surgery. Your physician will provide post-operative instructions regarding diet, rest, exercise and medications. You will be provided with a written summary of these discharge instructions. A nurse from Advanced Surgery Center of Orlando will attempt to call you the day after your surgery to check on your progress and discuss any questions you may have. If you have any unexpected problems, please call your doctor. If he/she does not respond, please go to the nearest emergency room. Thank you for choosing the Advanced Surgery Center of Orlando. Advanced Surgery Center of Orlando, LLC 6900 Turkey Lake Rd Ste 2-5 Orlando, FL 32819 Fax: 407-354-5403 © Copyright 2021 Advanced Surgery Center of Orlando. All rights reserved. Site design by WDS. Contact Home

407.354.5401 Driving Directions ▸ Before Surgery Day of Surgery After Surgery Patient Forms HOME PHYSICIANS FOR PATIENTS DIRECTIONS CONTACT CONTACT Advanced Surgery Center of Orlando, LLC 6900 Turkey Lake Rd Ste 2-5 Orlando, FL 32819 Phone: 407.354.5401 Fax: 407-354-5403 Advanced Surgery Center of Orlando, LLC 6900 Turkey Lake Rd Ste 2-5 Orlando, FL 32819 Fax: 407-354-5403 © Copyright 2021 Advanced Surgery Center of Orlando. All rights reserved. Site design by WDS. Contact Home

407.354.5401 Driving Directions ▸ Before Surgery Day of Surgery After Surgery Patient Forms HOME PHYSICIANS FOR PATIENTS DIRECTIONS CONTACT PHYSICIANS Nam L. Dinh, M.D. LEARN MORE ▸ Steve Vuong Nguyen, M.D. LEARN MORE ▸ Jerry A. Rubin, M.D. LEARN MORE ▸ Advanced Surgery Center of Orlando, LLC 6900 Turkey Lake Rd Ste 2-5 Orlando, FL 32819 Fax: 407-354-5403 © Copyright 2021 Advanced Surgery Center of Orlando. All rights reserved. Site design by WDS. Contact Home