• Patient Rights & Responsibilities - View and print our patient rights and responsibilities policy.
  • Privacy Notice - View and print our privacy notice.
  • Patient Guide - View and download our patient guide.
  • Nondiscrimination Notice - View and print our nondiscrimination policy.
  • Grievance Policy - View and print our grievance policy.
  • Authorization for Release of Information - View and print our release of information form.

    Complete the ROI form and return to Rockford Ambulatory Surgery Center by mailing it or faxing it to our Medical Record Department. You may also bring the form into our offices.

    Medical Record Department
    Rockford Ambulatory Surgery Center
    1016 Featherstone Rd.
    Rockford, IL 61107

    Telephone: 815-226-3300
    Fax: 815-226-9990

Rockford Ambulatory Surgery Center

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