The Plainfield Surgery Center, LLC is an outpatient surgery center where only elective procedures are performed. It is the policy of the Center that any Advance Directive will not be honored. .
The following Advance Directive Notification Policy has been instituted by Plainfield Surgery Center, in accordance with state laws and Federal ASC Regulation (42 C.F. R. 416.509(a) (2)):
- Patients are not required to have an Advance Directive: however, an inquiry will be made to patients during the preadmission phone call as to whether they have an Advance Directive.
- If the patient has an Advance Directive, a request for a copy will be made and placed on the medical record the day of surgery.
- In the event of a life-threatening situation, emergency measures/resuscitation will be initiated, the patient will be treated, stabilized, and transferred to a higher level of care, as necessary.
- In the event of a hospital transfer, a copy of the patient’s chart and a copy of the Advance Directive will be sent with the patient.
- As a courtesy to our patients, a copy of the State of Illinois “Statutory Short Form for Powers of Attorney for Health Care” can be provided to you upon request.
Additional information and forms can be found at: https://www2.illinois.gov/aging/AboutUs/pages/legal_adv-directives.aspx
Patient Rights and Responsibilities
For a copy of the Plainfield Surgery Center’s Patient Rights and Responsibilities click on the download button.
The Plainfield Surgery Center complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age disability, or sex. The Plainfield Surgery Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Plainfield Surgery Center Privacy Practices
To see the complete document click on the download button.
Patient Complaint & Grievance Procedure
If you have concerns about the quality of care and/or patient safety of this licensed ambulatory surgical treatment center, please notify any member of the our staff or the Clinical Nurse Manager. More information can be obtained by clicking the download button below.
Request Medical Record
If you would like to request your medical record, please click the download button for the Authorization for Release of Information. Complete the form and fax or mail to Plainfield Surgery Center ATTN: Medical Records
Plainfield Surgery Center
ATTN: Medical Records
24600 W 127th Street
Plainfield, IL 60585