Patient Guide

Appointment/Procedure Preparation

Roosevelt Surgical is committed to putting patients first and wants to help care for your surgical needs. A referring doctor may call to make an appointment, or a new patient may call us directly at (513) 424-0941(513) 424-0941 to schedule an appointment.

Any special instructions regarding your appointment will be discussed with you during the initial phone conversation.

We ask new patients to arrive 15 minutes prior to their initial appointment to complete any of the necessary forms from the list below: 

• Patient Registration Form - Adult
• Patient Registration Form - Minor
• Established Patient History Form
• Medical Release Form
• Verbal Communications Form
• Advance Directives Patient Education Form
• Advance Directives - Health Care Power of Attorney and Living Will

What to Expect

Your initial consultation at Roosevelt Surgical may include the following:

• Physical examination
• Review of your health history
• Review of pertinent reports
• Discussion of available options with risks and benefits of each
• Treatment decision once all your questions are answered 

What to Bring

All patients should bring:

• Your medications or a list of the medications you are currently taking
• A list of your known allergies
• Photo identification
• Your health insurance card(s)
• Patient registration forms, if you filled them out in advance 

All patients should come prepared to pay any co-pays, deductibles, or co-insurances at the time of their visit.

Hospital Pre-Registration

We encourage all patients scheduled for surgery to pre-register for their hospital visit. Taking the time to complete paperwork before you arrive for your procedure will make your check-in quicker and allow us to begin your services in less time. Pre-registration can be completed at your hospital’s registration office or online.

Billing and Insurance

Please verify your insurance coverage before your appointment and check our list of major insurance plans accepted by most providers at Premier Physician Network.

Premier Physician Network's custom service team is happy to answer any questions about billing and insurance. You can also find detailed billing and insurance information in the billing section.