Patient Information

When you arrive at Bay Surgery Center, please check-in at the reception desk, which is in the lobby. After you register, you will be escorted to the Surgical Pre-Procedure Area, where a nurse will assist you in preparing for your procedure. Please feel free to ask any questions and tell the staff about any special needs. We want your visit to be convenient and comfortable.

To provide everyone with the best possible care, it is very important that you arrive at your scheduled time. If you have any further questions before your scheduled appointment, please don’t hesitate to call Bay Surgery Center.

Before Surgery
DO NOT EAT OR DRINK ANYTHING after midnight, including water, mints or chewing gum. Undigested food in the stomach can cause complications and your surgery is likely to be postponed.

IF YOU ARE taking blood pressure, heart, seizure or asthma medication, take them the morning of surgery with a sip of water. If you use an inhaler, please bring it with you.

BATHE OR SHOWER the morning of surgery to minimize the chance of infection. Teeth may be brushed, but DO NOT swallow any water.

REFRAIN FROM SMOKING after midnight on the day preceding surgery.

IF YOU SUSPECT YOU ARE PREGNANT, please notify your surgeon. Anesthesia and medications may be harmful to the fetus.

IF YOU EXPERIENCE ANY HEALTH CHANGES between your most recent visit to your surgeon and the day of surgery, notify your surgeon. Please report even minor changes such as an elevated temperature, cough or cold.

BRING COMPLETED insurance forms, as well as your insurance cards and medical information. PLEASE CHECK with your insurance company for pre-admission requirements such as second opinions, pre-admission certification, co-pays or deductibles. This will facilitate the admitting process.

ARRANGE FOR AN ADULT to be at Bay Surgery Center during surgery and to drive you home, as you cannot drive yourself after surgery. YOU SHOULD ALSO ARRANGE to have someone stay with you for the first 24 hours following your surgery.

Helpful Hints
YOU WILL be required to remove jewelry, so leave jewelry and valuables at home.

YOU MAY be required to remove make-up or nail polish depending on the type of procedure being performed.

WEAR COMFORTABLE, loose clothing. During surgery you will wear a patient gown provided by the Center.

WEAR FLAT, comfortable slip-on shoes.

After Surgery
We will give you some general rules to supplement the instructions you may receive from your doctor.

Follow the doctor’s instructions regarding diet, rest and medication.

Feeling dizzy and sleepy after a procedure is not unusual.

Surgical guests are advised not to drive, make important decisions or sign any important papers at least 24 hours following a procedure.

Our staff will call to check on your progress.

Patients who are scheduled for surgery are encouraged to complete their required pre-operative forms prior to coming in. This will help expedite your process on the day of your surgery.

Adobe Acrobat Reader is required to view, fill out and print forms. You may open and print these forms, complete and then bring to our office. You may also save the form to your computer, open and edit online, then save and print. Please do not email completed forms, as email is not a secure form of communication.

New Patient Packet

Returning Patient Packet

Advance Healthcare Directive Form – Instructions

Advance Healthcare Directive Form

As a patient you have the following rights regarding your treatment:

1.   Receive safe, considerate and respectful care, without discrimination, and respect for your cultural, psychosocial, spiritual and personal values, beliefs, and preferences; and free from mental, physical, sexual or verbal abuse and neglect, exploitation or harassment.
2.   Participate in and make informed decisions about your care and pain management, and receive as much information about any proposed treatment or procedure as you need in order to give informed consent or to refuse a course of treatment.
3.   Request or refuse treatment or leave the surgery center even against the advice of physicians, to the extent permitted by law. However, you do not have the right to demand inappropriate or medically unnecessary treatment or services.
4.   Have your condition, treatment plan, pain alternatives and prognosis explained in a manner that you understand. You have the right to participate in ethical questions that arise in the course of your care, including issues of conflict resolution.
5.   Reasonable response to reasonable requests for service.
6.   Receive private and confidential treatments, communications, and medical records. You have the right to be told the reason for the presence of any individual and to have visitors leave prior to an examination. Privacy curtains will be used in semi-private rooms. You will receive a separate “HIPAA Patient Consent Form” that explains your privacy rights in detail and how we may use and disclose your protected health information.
7.   Know the name and role of your caregiver (e.g., doctor, nurse, technician, etc.). You have a right to request information and/or credentials about the physician providing your care.
8.   Be fully informed of the scope of service available at the facility, know in advance time and location of appointments as well as the identity of the persons providing care, continuing health care requirements, options following discharge from the surgery center, and provisions for after hours and emergency care. You have the right to be involved in the development and implementation of your discharge plan. A friend or family member may be provided with this information upon your request.
9.   Information regarding fees for service, payment policies and financial obligations.
10. Be free from restraints and seclusion of any form used as a means of coercion, discipline, convenience or retaliation by staff.
11. Be informed of any human experimentation or other research/educational projects affecting his/her care or treatment and can refuse participation in such experimentation or research without compromise to the patient’s usual care.
12. Formulate and be given an opportunity to receive information regarding advance directives. Regardless of the contents of any advance directive or instructions from a health care surrogate or attorney, if an adverse event occurs during a patient’s treatment, Bay Surgery Center personnel will initiate resuscitative and/or stabilizing measures and transfer the patient to an acute care hospital for further evaluation. If a copy of your advance directive was provided to us, it will be sent to the acute care hospital. Copies of the Advance Health Care Directive Kit are available at this facility.
13. Exercise your rights without regard to sex, race, color, religion, ancestry, national origin, age, disability, medical condition, marital status, sexual orientation, gender identification, educational background, economic status, source of payment for care, or fear of reprisal.
14. Receive marketing or advertising materials that reflects the services of the surgery center in a way which is not misleading.
15. Designate visitors of your choosing, if you have decision making capacity, whether or not the visitor is related by blood or marriage, unless: 1) No visitors are allowed. 2) The facility reasonably determines that the presence of a particular visitor would endanger the health or safety of a patient, a member of the health facility staff or other visitor to the health facility, or would significantly disrupt the operations of the facility, or 3) You have told the health facility staff that you no longer want a particular person to visit.
16. To know that your physician may or may not have an ownership interest in Bay Surgery Center as not all physicians who practice here have an ownership interest. As a patient, you have the right to receive a list of all physician owners in this facility, upon request.
17. File a grievance. Each patient has the right to present complaints or grievance to any employee; by completing the Patient Satisfaction Questionnaire, in writing or phone. The grievance committee will review each grievance and provide you with a written response within 10 days. The written response will contain the name of a person to contact at the surgery center, the steps taken to investigate the grievance, the results of the grievance process, and the date of completion of the grievance process. You have a right to file a complaint with the state Department of Public Health regardless of whether you use the surgery center’s grievance process.

Thomas Durick, MD, Medical Director
Bay Surgery Center
6633 Telegraph Avenue, Suite B
Oakland, CA 94609-1116
(510) 841-2179

California Department of Public Health
District Manager
850 Marina Bay Parkway
Richmond, CA 94804-6403
(510) 307-8409

All patients should visit the Office of the Medicare Beneficiary Ombudsman website to understand your rights and protections or call 1-800-MEDICARE (1-800-633-4227).

As a patient you have the responsibility of:

1.   Providing to the best of your knowledge, an accurate and complete description of your present condition and past medical history, including past illnesses, medications, including over-the-counter products, dietary supplements, allergies, sensitivities and prior hospitalizations/procedures.
2.   Informing your provider about any living will, medical power of attorney or other directive that could affect your care.
3.   Indicating if you feel your privacy is being violated or safety is being threatened.
4.   Reporting any changes in your condition to your physician and indicating whether you understand a suggested course of action
5.   Asking your doctor or nurse what to expect regarding pain and pain management and discuss pain relief options. Tell your doctor or nurse if your pain is not relieved and any worries you have about pain medication.
6.   Being respectful and considerate of all health care providers, staff and other patients.
7.   Making an effort to understand your health care needs and asking your physician or other members of the health care team for information relating to your treatment.
8.   Informing those who treat you whether or not you think you can and want to permit or decline specific treatment.
9.   Following and taking responsibility for your well being if you refuse treatment or fail to follow the practitioner’s instructions.
10. Providing a responsible adult to transport you home from the facility and remain with you for 24 hours.
11. Meeting your financial commitment, including personal financial responsibility for any charges not covered by insurance.