Our Patient Forms | Rock Surgery Center in Derby KS

Patient Forms

For your convenience, we have gathered important forms that you should review and/or complete prior to your arrival for surgery. If you are not able to download these forms in advanced, we will have the forms ready for you when you show up for your scheduled surgery. Please allow additional time to complete the forms.

  • Patient Guide
  • Patient Rights
  • Patient Responsibilities
  • Privacy Policy

Patients Rights

We respect our patients’ dignity and pride which is why we go out of the way to ensure each patient knows their rights, and responsibilities when coming to the Rock Surgery Center for their scheduled procedure. We encourage each patient to understand their rights.


Please call our facility at 316-771-9999 if you have any questions. One of our knowledgeable team members will be happy to help you.

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(316) 771-9999

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