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Patient Forms

Here is a list of the most common forms are used at Powder River Surgery Center. Please complete and print them, then bring with you for your visit.

If you have any questions call 307.688.8600.

Need Adobe Reader? Click here to download it for free.

Patient Satisfaction Survey's

Please complete after surgery
Pain Management Patient Satisfaction Survey
PRSC Patient Satisfaction Survey

The Release of Information Form (in the Adult/Child Intake Forms) must be completed in its entirety before any medical records can be released. The patient's signature and a copy of their photo ID is also required, along with a witness signature. (It can be anybody over the age of 18).

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